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Leif Mosekilde - One of the best experts on this subject based on the ideXlab platform.

Maurizio Bossola - One of the best experts on this subject based on the ideXlab platform.

  • predictive factors for recurrence after thyroid lobectomy for unilateral non Toxic Goiter in an endemic area results of a multivariate analysis
    Surgery, 2004
    Co-Authors: Rocco Domenico Alfonso Bellantone, Celestino Pio Lombardi, Mauro Boscherini, Marco Raffaelli, Vincenzo Tondolo, Pier Francesco Alesina, Salvatore Maria Corsello, Danilo Fintini, Maurizio Bossola
    Abstract:

    Background The aim of the study was to identify the factors that are predictive of recurrence after thyroid lobectomy for unilateral non-Toxic thyroid Goiter in an endemic region through a multivariate analysis. Methods Two hundred sixty-eight consecutive patients who underwent thyroid lobectomy and who were evaluated by the same endocrinologist were included. Univariate and multivariate analysis analyzed the relationship between sex, age, preoperative thyroid-stimulating hormone, duration of disease, duration of levothyroxine (LT4) preoperative therapy, cytologic results, histologic results, resected thyroid weight, numbers and diameters of thyroid nodules, morphologic alterations of the remnant lobe, follow-up length, postoperative LT4 therapy, ultrasonographic evidence of recurrence, and reoperation. Results The incidence of recurrence was 33.9% (91/268 patients) after a mean follow-up time of 79.9 months (range, 12-251 months), female sex ( P  = .016), multiple nodules ( P  = .017), and lack of postoperative LT4 therapy ( P  = .0009) were predictive factors of recurrence. Reoperation was performed in 20 patients (7.4%); factors that were predictive of reoperation were the presence of multiple nodules ( P  = .008), resected thyroid weight ( P  = .00006), and lack of postoperative hormonal therapy ( P  = .0005). Conclusions Thyroid lobectomy for unilateral non-Toxic Goiter, when combined with suppressive or substitutive thyroxin therapy, resulted in a low rate of recurrence and reoperation in an endemic area.

Birte Nygaard - One of the best experts on this subject based on the ideXlab platform.

  • Radioiodine therapy for multinodular Toxic Goiter.
    Archives of Internal Medicine, 1999
    Co-Authors: Birte Nygaard, Laszlo Hegedüs, Peter Ulriksen, Kamilla Gerhard Nielsen, Jens Mølholm Hansen
    Abstract:

    Background: Radiolabeled iodine 131 therapy is used for treatment of multinodular Toxic Goiter, but long-term follow-up studies are lacking. Methods: A prospective study of 130 consecutive patients (115 women) treated with 131 I for multinodular Toxic Goiter and followed by evaluation of thyroid volume (determined using ultrasound) and thyroid function variables. Results: The patients were observed for a median of 72 months (range, 12-180 months). Sixty-six patients received antithyroid drug pretreatment; 64 did not. Iodine 131 treatment (3.7 MBq/g thyroid tissue corrected to a 100% 24-hour 131 I uptake) was given as a single dose in 81 patients, 2 doses in 38, and 3 to 5 doses in 11. One or 2 treatments cured 119 patients (92%), and 68 (52%) became euthyroid within 3 months after 1 131 I treatment. The median 131 I dose was 370 MBq (range, 93-1850 MBq). Forty-nine patients needing more than 1 131 I dose had a reduction in median thyroid volume from 56 mL (range, 21-430 mL) to 44 mL (range, 15-108 mL), representing a 24% reduction related to the insufficient 131 I dose. In all patients, the initial median thyroid volume of 44 mL (range, 16-430 mL) decreased to 25 mL (range, 8-120 mL) (P

  • radioiodine therapy for multinodular Toxic Goiter
    JAMA Internal Medicine, 1999
    Co-Authors: Birte Nygaard, Laszlo Hegedüs, Peter Ulriksen, Kamilla Gerhard Nielsen, J M Hansen
    Abstract:

    Background: Radiolabeled iodine 131 therapy is used for treatment of multinodular Toxic Goiter, but long-term follow-up studies are lacking. Methods: A prospective study of 130 consecutive patients (115 women) treated with 131 I for multinodular Toxic Goiter and followed by evaluation of thyroid volume (determined using ultrasound) and thyroid function variables. Results: The patients were observed for a median of 72 months (range, 12-180 months). Sixty-six patients received antithyroid drug pretreatment; 64 did not. Iodine 131 treatment (3.7 MBq/g thyroid tissue corrected to a 100% 24-hour 131 I uptake) was given as a single dose in 81 patients, 2 doses in 38, and 3 to 5 doses in 11. One or 2 treatments cured 119 patients (92%), and 68 (52%) became euthyroid within 3 months after 1 131 I treatment. The median 131 I dose was 370 MBq (range, 93-1850 MBq). Forty-nine patients needing more than 1 131 I dose had a reduction in median thyroid volume from 56 mL (range, 21-430 mL) to 44 mL (range, 15-108 mL), representing a 24% reduction related to the insufficient 131 I dose. In all patients, the initial median thyroid volume of 44 mL (range, 16-430 mL) decreased to 25 mL (range, 8-120 mL) (P<.005), representing a median reduction of 43%, 24 months after the last 131 I dose. Hypothyroidism evaluated using life-table analysis developed in 6% of patients who did not receive antithyroid pretreatment and 20% who did (P<.005) after a median of 42 months (range, 3-60 months), the total hypothyroidism frequency being 14% within 5 years of treatment. Conclusions: Ninety-two percent of patients with multinodular Toxic Goiter were cured with 1 or 2 treatments. The thyroid volume was reduced by 43%, with few side effects. Iodine 131 should be the choice of treatment in patients with multinodular Toxic Goiter.

  • graves disease and thyroid associated ophthalmopathy triggered by 131i treatment of non Toxic Goiter
    Journal of Endocrinological Investigation, 1999
    Co-Authors: Birte Nygaard, R A Metcalfe, J Phipps, A P Weetman, Laszlo Hegedüs
    Abstract:

    A 39-year-old Danish woman was treated with an oral dose of 400 MBq 131I for a non-Toxic Goiter with compression symptoms. Serum anti-TPO and TSH receptor antibodies were negative before radioiodine therapy. The patient developed hyperthyroidism four months after treatment and ophthalmopathy after another three months. TSH receptor stimulating and blocking antibodies, eye muscle IgA and IgG were measured and an increase in stimulating TSH receptor antibodies were found concomitant with development of hyperthyroidism. IgG class antibodies against porcine eye muscle antigens and eye muscle fibroblasts were elevated and unchanged during the follow-up. A significant increase in IgA class antibodies against porcine eye muscle antigens was seen concomitant with development of ophthalmopathy. It is speculated that 131I has led to an exacerbation of eye muscle as well as TSH receptor stimulating antibodies and possibly leading to the development of ophthalmopathy, or at least is associated with it.

  • Transition of nodular Toxic Goiter to autoimmune hyperthyroidism triggered by 131I therapy.
    Thyroid, 1999
    Co-Authors: Birte Nygaard, Jens Faber, Annegrete Veje, Laszlo Hegedüs, Jens Mølholm Hansen
    Abstract:

    The use of 131I treatment in nodular Toxic Goiter is widely accepted. In this article, we describe transition of nodular Toxic Goiter into an autoimmune Toxic Goiter with development of thyrotropin...

Peter Vestergaard - One of the best experts on this subject based on the ideXlab platform.

J M Hansen - One of the best experts on this subject based on the ideXlab platform.

  • radioiodine therapy for multinodular Toxic Goiter
    JAMA Internal Medicine, 1999
    Co-Authors: Birte Nygaard, Laszlo Hegedüs, Peter Ulriksen, Kamilla Gerhard Nielsen, J M Hansen
    Abstract:

    Background: Radiolabeled iodine 131 therapy is used for treatment of multinodular Toxic Goiter, but long-term follow-up studies are lacking. Methods: A prospective study of 130 consecutive patients (115 women) treated with 131 I for multinodular Toxic Goiter and followed by evaluation of thyroid volume (determined using ultrasound) and thyroid function variables. Results: The patients were observed for a median of 72 months (range, 12-180 months). Sixty-six patients received antithyroid drug pretreatment; 64 did not. Iodine 131 treatment (3.7 MBq/g thyroid tissue corrected to a 100% 24-hour 131 I uptake) was given as a single dose in 81 patients, 2 doses in 38, and 3 to 5 doses in 11. One or 2 treatments cured 119 patients (92%), and 68 (52%) became euthyroid within 3 months after 1 131 I treatment. The median 131 I dose was 370 MBq (range, 93-1850 MBq). Forty-nine patients needing more than 1 131 I dose had a reduction in median thyroid volume from 56 mL (range, 21-430 mL) to 44 mL (range, 15-108 mL), representing a 24% reduction related to the insufficient 131 I dose. In all patients, the initial median thyroid volume of 44 mL (range, 16-430 mL) decreased to 25 mL (range, 8-120 mL) (P<.005), representing a median reduction of 43%, 24 months after the last 131 I dose. Hypothyroidism evaluated using life-table analysis developed in 6% of patients who did not receive antithyroid pretreatment and 20% who did (P<.005) after a median of 42 months (range, 3-60 months), the total hypothyroidism frequency being 14% within 5 years of treatment. Conclusions: Ninety-two percent of patients with multinodular Toxic Goiter were cured with 1 or 2 treatments. The thyroid volume was reduced by 43%, with few side effects. Iodine 131 should be the choice of treatment in patients with multinodular Toxic Goiter.