Clinical Efficacy of A Single Dose Radioiodine Therapy for Hyperthyroidism

<p><strong>Objective</strong>: Radioiodine is a safe, cheap, and recognized permanent treatment option for patients with hyperthyroidism. Despite, the extensive use of radioiodine therapy in hyperthyroidism there is no consensus regarding the optimal dose of radioiodine. To evaluate the clinical efficacy and our clinical experience with the use of a single dose radioiodine therapy for hyperthyroidism in our institution.</p><p><strong>Methods:</strong> A total of 274 patients who received a single dose of radioactive iodine therapy for hyperthyroidism at our institution between 2007-2015 were retrospectively reviewed. Of these, 186 patients had Graves’ disease (GD), 73 patients had Plummer’s disease (PD), and 15 patients had a single toxic adenoma (STA). All patients received between 10-30mCi of oral radioiodine capsule. The efficacy of therapy was determined 3 months post-therapy using serum thyroid function test, weight and heart rate measurements. Therapy success refers to patients whose outcome was euthyroidism and hypothyroidism post-therapy and treatment failure where patients still manifested with persistent hyperthyroidism.</p><p><strong>Results:</strong> The efficacy of a single dose of radioiodine 3months post-therapy varies with the type of hyperthyroidism, 96% for Graves’s disease, 92% for Plummer’s disease and 100% in single toxic adenoma.</p><p><strong>Conclusion:</strong> Our study showed that a single dose of radioactive iodine therapy 3 months post-therapy is 96% efficient in all types of hyperthyroidism. However, we observed that patients at risk of therapy failure 3month post-therapy included, large thyroid gland prolong antithyroid drug usage and male gender.</p><p> </p>

The Relationship Between GATED Myocardial Perfusion SPECT Findings and Heart Rate Recovery After Exercise Test

<p><strong>Objective: </strong>Coronary artery disease has been thought that autonomic nervous system dysfunction especially increased sympathetic tonus and relatively decreased parasympathetic activity is related to coronary artery disease. Abnormal heart rate recovery after exercise test, is a simple available parameter, that reflects autonomic nervous system disfunction. GATED myocardial perfusion SPECT is used in the diagnosis and prognosis of coronary artery disease. In this study we compared heart rate recovery with myocardial perfusion scintigraphy findings.</p><p><strong>Methods:</strong> In our study there were 50 subjects (27 female, 23 male). Multiple lineer regression analysis was used to determine relationship between heart rate recovery and GATED myocardial perfusion SPECT parameters, age, gender, and history.</p><p><strong>Results:</strong> Multiple lineer regresion revealed strong independent negative assosiation between heart rate recovery and myocardial defect severity on stress images (β= -0.957; SE= 0.650; p= 0.043). Age was also an independent predictor of heart rate recovery with negative assosiation (β= -0.473; SE= 0.250; p= 0.022). Correlation coefficient (R) and R square (R²) of the model were 0.604, and 0.365 respectively.</p><strong>Conclusion:</strong> On stresss protocol, myocardial damage is more severe in patients who have decreased heart rate recovery. Since the severity of myocardial damage on stresss is a strong predictor of cardiac events and prognosis, heart rate recovery was also have prognostic value on future cardiac events.

Dislodging of an Impacted Meat Bolus in The Esophagus Using Interventional Barium Swallow Technique

Impacted oesphageal foreign body is a common condition. Its removal with rigid oesphagoscopy is challenging and carries a significant risk of oesphageal perforation. We present a case of an impacted meat bolus, which was successfully dislodged using barium swallow technique. The rarity of barium swallow in intervention radiology and the importance of creating awareness among radiologist and otolargyngologist of this therapeutic option are emphasized.