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Biomedical subjects

M Piccolo

Publications and source records attributed to M Piccolo.

At least 37 records · Page 2Linked to original sources
PubMed1990

Usefulness of the combined antithyroglobulin antibodies and thyroglobulin assay in the follow-up of patients with differentiated thyroid cancer.

A total of 1050 patients with differentiated thyroid cancer (DTC) have been followed in the Thyroid Center of Padua by means of serum thyroglobulin (Tg) measured with IRMA method and anti-Tg antibodies (TgAb) assays. Circulating TgAbs were detected in 102 (9.7%) patients. In 32 of these 102, TgAbs were evaluated before and after total thyroidectomy and 131I ablation. In these patients no relationship was found between preoperative serum TgAb levels on the one hand and tumor stage at diagnosis or outcome of the disease on the other. During the follow-up, TgAb serum levels decreased or disappeared in 21 cases considered tumor-free, while they remained unchanged or even increased, in comparison with the preoperative ones, in 11 patients, 5 with proven metastases and 6 considered tumor-free. Evaluating the whole group of 102 TgAb-positive patients, we observed that TgAb serum levels, measured after thyroid ablation, were significantly higher in cases with metastases than in those considered tumor-free (653.0 +/- 196.9 vs 157.7 +/- 116.5 U/ml, m +/- SD, p less than 0.0001). In the group of patients with metastases and circulating TgAbs, Tg serum levels were elevated in 27% of cases on TSH-suppressive therapy and in 44% off therapy when nodal metastases were present, and in 67% of cases on TSH-suppressive therapy and in 83% off therapy when distant metastases were present.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1989

Severe hyperthyroidism due to neoplastic TSH hypersecretion in an old man.

A case is reported of neoplastic TSH hypersecretion in a 62-year-old man with severe hyperthyroidism and cardiovascular disease. He had been known to be hyperthyroid for 14 yr, and had been treated by thyreostatic drugs and subtotal thyroidectomy without satisfactory results. When he was referred to our Center, he was frankly hyperthyroid with both TSH (14 microU/ml) and thyroid hormone serum levels (TT4 24 micrograms/dl, TT3 370 ng/dl, FT41 7.9) above the normal range. alpha-subunit serum level was markedly increased (7.2 ng/ml), while beta-subunit was only 0.3 ng/ml. Skull X-ray showed an enlarged sella turcica with destruction of the dorsum and an intrasellar tumor was visualized on conventional and computer tomography. TSH response was absent after TRH and domperidone, while TSH serum levels decreased by 25% after bromocriptine. Methimazole therapy temporarily decreased serum thyroid hormones to normal levels, while TSH levels rose to 34 microU/ml, thus indicating that pituitary-thyroid feed-back was maintained at a higher set point. Surgical attempt failed because of cardiac problems during anesthesia. Radiotherapy plus methimazole was begun and TSH serum levels first increased markedly, up to 140 microU/ml, and then progressively decreased without reaching normal values. After methimazole withdrawal hyperthyroidism recurred.

Bromocriptine↗
PubMed1986

Critical evaluation of serum thyroglobulin (Tg) levels during thyroid hormone suppression therapy versus Tg levels after hormone withdrawal and total body scan: results in 291 patients with thyroid cancer.

Serum thyroglobulin (Tg) levels were measured during thyroid-hormone suppressive therapy in 291 patients who had been treated for well-differentiated thyroid carcinoma. The findings were compared with those of a subsequent total body scan (TBS) and with Tg levels measured after thyroid-hormone withdrawal. Of the patients with low Tg levels during suppressive therapy, 91.6% were subsequently shown to be free of disease or to have only remnants in the thyroid bed, whereas 8.4% had metastases (false-negative). Of the patients with false-negative findings, 89.3% had nodal metastases; 60.8% of the patients with nodal metastases exhibiting radioiodine uptake and only 23% of those with nonfunctioning nodal metastases had low Tg levels during suppression therapy. After thyroid-hormone withdrawal, all but 1 of the patients with nodal metastases had high Tg levels. All but 2 of the patients with distant metastases had high Tg levels during suppression therapy; 1 of these 2 patients exhibited high Tg levels after T3 withdrawal. No differences between Tg levels in patients with functioning and non-functioning metastases were found. Our study indicates that Tg assays performed during suppressive therapy have a fairly good predictive value and can be used as a general guide in the follow-up of thyroid cancer. However, since most differentiated metastases produce Tg only when stimulated by thyroid-stimulating hormone, measurements of Tg levels after the discontinuation of suppressive therapy would also seem to be necessary.

Adolescent↗
PubMed1986

Sexual activity after coronary bypass surgery.

Although successful rehabilitation of coronary artery bypass surgery (CABS) patients should include consideration of their sexuality, there is a paucity of data regarding their sexual activity (SA). One hundred thirty-four patients were interviewed in regard to the impact of surgery on their sexuality and the relation of SA to their work status. Eighty-four of the 92 previously sexually active patients and two of the inactive ones resumed SA. Sexual dissatisfaction prior to surgery was a negative factor (p less than .05), while return to work, in the group that was working before, was positive (p less than .05) for resumption of SA. The average time before resumption of SA after CABS was 7.8 weeks. Thirty-nine percent of patients decreased the frequency of SA. Seventeen percent of patients and 35 percent of their partners expressed fear of resumption of SA. Twenty-three percent of patients had symptoms during intercourse. The couples who resumed sexual activity had a closer emotional relationship (p less than .02). Two-thirds of the patients received sexual instructions, but in only 20 percent of the cases did the physician himself initiate discussion. Although after CABS patients fare much better in regard to SA when compared to myocardial infarction patients reported in other studies, CABS does not provide a net gain in SA and sexual functioning. Comprehensive sexual counseling is still not being adequately addressed.

Adult↗