PubMed Health⌕ Search

Biomedical subjects

N Gómez

Publications and source records attributed to N Gómez.

At least 19 recordsLinked to original sources
PubMed2006

Role of TNFRp55 in Yersinia enterocolitica O:3-induced arthritis: triggering bacterial antigens and articular immune response.

OBJECTIVES: The pathogenesis of reactive arthritis (ReA), an aseptic synovitis that follows an extra-articular infection, is incompletely known. We studied the impact of tumour necrosis factor receptor (TNFR) p55 deficiency on the progression to ReA after oral Yersinia enterocolitica O:3 infection, the Yersinia antigens triggering articular inflammation and a possible articular TNFRp55-mediated mechanism that protects against ReA. METHODS: Wild-type C57BL/6 and TNFRp55-/- mice were orogastrically infected with Y. enterocolitica O:3 and monitored for survival and arthritis development. The bacterial load was determined in mesenteric lymph nodes (MLNs), the spleen and joints. Interferon (IFN)-gamma, TNF-alpha and IL-10 mRNA expression in MLN and joints were analysed by reverse transcription-polymerase chain reaction (RT-PCR). Articular antibodies to Yersinia antigens, TNF-alpha protein and nitric oxide (NO) levels were assessed. Acute arthritis was evaluated after joint injection of Yersinia antigens. RESULTS: The survival rate was 60% in TNFRp55-/- mice. They showed impaired bacterial clearance in MLN, the spleen and joints, and excessive mRNA expression of pro-inflammatory cytokines in MLN. Clinical and histological examinations revealed that TNFRp55-/- mice developed severe arthritis. Moreover, augmented articular outer membrane protein (OMP)-specific antibodies and TNF-alpha but impaired NO levels were detected in TNFRp55-/- mice. Synovial inflammatory response was detected by joint OMP injection. CONCLUSIONS: TNFRp55-mediated immune mechanisms prevent ReA development after oral infection with Y. enterocolitica O:3. Yersinia OMPs are the relevant antigens triggering ReA. NO induction through TNFRp55 signalling could have a local antibacterial function to prevent ReA. This study could contribute to ReA-specific therapeutic studies.

Animals↗
PubMed2006

Pulsed electric fields cause bacterial envelopes permeabilization depending on the treatment intensity, the treatment medium pH and the microorganism investigated.

The relationship between membrane permeabilization and loss of viability by pulsed electric fields (PEF) depending on the treatment intensity and the treatment media pH in two gram-positive (Lactobacillus plantarum, Listeria monocytogenes) and two gram-negative (Escherichia coli, Salmonella senftenberg 775W) bacterial species has been investigated. Loss of membrane integrity was measured as increased uptake of the fluorescent dye propidium iodide (PI). Non-permanent/reversible permeabilization was detected when cells stained with PI during PEF resulted in higher fluorescence than that measured in cells stained after PEF. Whereas loss of viability of the two gram-negative bacteria was correlated with the sum of non-permanent and permanent membrane permeabilization when treated at pH 7.0, in the case of the two gram-positives, loss of viability was correlated with a permanent loss of membrane integrity. At pH 7.0, the four bacteria exhibited reversible permeabilization. However, whereas the gram-positives capable of reversing permeabilization survived, the gram-negative cells died, despite their capacity to reverse permeabilization immediately after PEF. Thus, resealing is not necessarily related to the survival of PEF-treated cells. In contrast, when cells were PEF-treated at pH 4.0 a more complicated picture emerged. Whereas loss of viability was correlated with a permanent loss of membrane integrity in L. monocytogenes cells, in L. plantarum the degree of permeabilization was higher, and in the gram-negative strains, much lower than the percentage of inactivated cells. These results support the view that membrane permeabilization is involved in the mechanism of bacterial inactivation by PEF, but the nature of membrane damage and its relationship with cell death depends on the bacterial species and the treatment medium pH.

Bacterial Outer Membrane Proteins↗
PubMed2006

Diagnosis of the nervous form of Maedi-Visna infection with a high frequency in sheep in Castilla y Leon, Spain.

Between 1997 and March 2004, the nervous form, or visna, of maedi-visna infection was diagnosed in 71 of 1631 sheep (4.35 per cent) examined in the Castilla y León region of Spain, of which 634 had shown nervous signs. The presence of the virus was confirmed by immunohistochemistry and in some cases by pcr on frozen-thawed or paraffin-embedded tissue samples. The main clinical signs were hindleg ataxia and paresis, but blindness or nystagmus were also observed. Thirty-three of the affected sheep (46.5 per cent) were two years old or younger. The affected sheep showed variable degrees of a non-suppurative meningoencephalitis, and immunohistochemistry identified positive cells in all cases, with no relation to the intensity of the inflammatory lesion.

Aging↗
PubMed2006

Biosynthetic requirements for the repair of sublethal membrane damage in Escherichia coli cells after pulsed electric fields.

AIMS: The aim was to evaluate the biosynthetic requirements for the repair of sublethal membrane damages in Escherichia coli cells after exposure to pulsed electric fields (PEF). METHODS AND RESULTS: The partial loss of the barrier and homeostatic functions of the cytoplasmic membrane was examined by adding sodium chloride to the recovery media. More than 4 log10 cycles of survivors were sublethally injured after PEF. Repair of such sublethal membrane damages occurred when survivors to PEF were incubated in peptone water for 2 h. Two different types of sublethally injured cells were detected. Whereas a small proportion (<5%) repaired after PEF in less than 2 min, the repair of the remaining 95% injured cells lasted 2 h and was dependent on biosynthetic requirements. The addition of inhibitors such as chloramphenicol, cerulenin, penicillin G, rifampicin and sodium azide to the liquid repair medium showed that the repair required energy and lipid synthesis, and was not dependent on protein, peptidoglican or RNA synthesis. CONCLUSIONS: Cell survival after PEF is dependent on the repair of the cytoplasmic membrane. Requirement of lipid synthesis for the repair of sublethally injured cells confirms that the cytoplasmic membrane is a target directly involved in the mechanism of inactivation by PEF. SIGNIFICANCE AND IMPACT OF THE STUDY: Knowledge about the damages inflicted by PEF might help in the design of more efficient treatments.

Anti-Bacterial Agents↗
PubMed2005

Modelling inactivation of Listeria monocytogenes by pulsed electric fields in media of different pH.

A study of the effect of square-wave pulsed electric fields (PEF) on the inactivation of Listeria monocytogenes in McIlvaine buffer of different pH (3.5-7.0) was conducted. L. monocytoges was more PEF sensitive at higher electric field strengths (E) and in media of low pH. A treatment at 28 kV/cm for 400 mus that inactivated 1.5, 2.3 and 3.0 Log10 cycles at pH 7.0, 6.5 and 5.0 respectively destroyed almost 6.0 Log10 cycles at pH 3.5. The general shape of survival curves of L. monocytogenes PEF treated at different pH was convex/concave upwards. A mathematical model based on the Weibull distribution accurately described these survival curves. At each pH, the shape parameter (n value) did not depend on E. The relationship between n value of the Weibull model and the pH of the treatment medium was described by the Gompertz equation. A multiple linear regression model using three predictor variables (E, E2, pH2) related the Log10 of the scale paramenter (b value) of the Weibull model with E and pH of the treatment medium. A tertiary model developed using McIlvaine buffer as treatment medium predicted satisfactorily the inactivation of L. monocytogenes in apple juice.

Colony Count, Microbial↗
PubMed2005

Pulmonary embolism in a patient with severe congenital deficiency for factor V during treatment with fresh frozen plasma.

Thrombosis is a rare complication in patients with congenital clotting factor deficiencies. In most cases, it is related to inherited procoagulant factors, use of central venous catheters or administration of coagulation factor concentrates. There are only a few case reports about thrombotic events during treatment with fresh frozen plasma (FFP). We report the case of a patient with homozygous inherited factor V deficiency, who developed a pulmonary embolism at a time of treatment with methylene blue treated FFP (MBFFP). The patient had only two other factors predisposing to thrombosis and both were acquired: obesity and bed rest. He started anticoagulant treatment with low molecular weight heparin (LMWH) while the deficient factors were replaced with MBFFP. After 8 days of treatment the patient developed a severe respiratory insufficiency. Pulmonary haemorrhage was considered among the differential diagnosis and LMWH was stopped. An inferior vena cava filter was placed without any further thrombotic complications. To our knowledge, there are no reports about patients with clotting factor deficiencies who developed a thrombotic event during treatment with MBFFP.

Adult↗
PubMed2005

Occurrence of sublethal injury after pulsed electric fields depending on the micro-organism, the treatment medium ph and the intensity of the treatment investigated.

AIMS: The objective was to investigate the occurrence of sublethal injury after pulsed electric field (PEF) depending on the treatment time, the electric field strength and the pH of the treatment media in two Gram-positive (Bacillus subtilis ssp. niger, Listeria monocytogenes) and six Gram-negative (Escherichia coli, Escherichia coli O157:H7, Pseudomonas aeruginosa, Salmonella serotype Senftenberg 775W, Salmonella serotype Typhimurium, Yersinia enterocolitica) bacterial strains. METHODS AND RESULTS: A characteristic behaviour was observed for the Gram-positive and Gram-negative bacteria studied. Whereas Gram-positive bacteria showed a higher PEF resistance at pH 7.0, the Gram-negative were more resistant at pH 4.0. In these conditions, in which bacteria showed their maximum resistance, a large proportion of sublethally injured cells were detected. In most cases, the longer the treatment time and the higher the electric field applied, the greater the proportion of sublethally injured cells that were detected. No sublethal injury was detected when Gram-positive bacteria were treated at pH 4.0 and Gram-negative at pH 7.0. CONCLUSIONS: Sublethal injury was detected after PEF so, bacterial inactivation by PEF is not an 'all or nothing' event. SIGNIFICANCE AND IMPACT OF THE STUDY: This work could be useful for improving food preservation by PEF.

Bacillus subtilis↗
PubMed2004

Relationship between 25-(OH) D3, the IGF-I system, leptin, anthropometric and body composition variables in a healthy, randomly selected population.

OBJECTIVE: This study prompted us to investigate the relationship between 25-(OH) D (3) and the IGF-I system, leptin, sex, age, anthropometric and body composition variables in healthy adults. We hypothesised that these variables would regulate 25-(OH) D (3) concentrations. DESIGN: We included 253 subjects--126 men and 127 women. Body mass index (BMI) and body composition was determined, along with serum leptin, total IGF-I, free IGF-I, IGFBP3 and plasma 25-(OH) D (3) concentrations. RESULTS: 25-(OH) D (3) deficiency was observed in 69 subjects. There was a difference between 25-(OH) D (3) values and season (summer vs. winter). We observed similar 25-(OH) D (3) concentrations in men to those in women. The differential characteristics in subjects without 25-(OH) D (3) deficiency were lower BMI, fat mass and body fat and higher free IGF-I. We observed that leptin increased in the last decades and IGF-I system decreased by decade in both men and women. In subjects without 25-(OH) D (3) deficiency, there was a correlation between free IGF-I and 25-(OH) D (3) in men, and a negative correlation between 25-(OH) D (3) and age, BMI, fat mass and leptin and a positive correlation with total IGF-I in women. The multivariate linear regression analysis explained 37.8 % of 25-(OH) D (3) variability in men and 39 % in women, and only season and free IGF-I made an independent contribution to 25-(OH) D (3) in men, and season and fat mass in women. CONCLUSION: These data suggest that free IGF-I in men and fat mass in women could regulate 25-(OH) D (3) concentrations.

Adolescent↗
PubMed2004

Image quality and dose evaluation in spiral chest CT examinations of patients with lung carcinoma.

A study was undertaken to assess the quality of general chest CT examinations for indication of lung carcinoma according to the criteria proposed in the European Commission (EC) Guidelines, and to investigate their usefulness in the optimization of this practice. The criteria were evaluated for a sample of 100 examinations from five radiology departments in the Madrid area featuring single slice helical CT scanners with special emphasis on radiation dose and image quality. To determine the degree of compliance with the image criteria considered, the examinations were independently evaluated twice by five radiologists from the participating centres. A subsequent selection of the observers was made according to the consistency and independence of their readings. Dose measurements carried out in parallel supplied data to estimate the values of the CT dose indices (CTDI), dose-length product (DLP) and effective dose (E). The results show good compliance with the image criteria used - between 93% and 98% on average at the different sites, with variable degrees of internal deviation. 10 out of a total of 16 criteria proposed in the EC guidelines were met by practically all the examinations in the sample. The average weighted CTDI (CTDI(w)) values per site were in the range of 13-19 mGy; those of DLP were between 263 mGy cm and 577 mGy cm, and those of effective dose between 4 mSv and 9 mSv. The highest mean DLP value was below but close to the reference value proposed in the EC Document (650 mGy cm). In general, a weak correlation or no correlation at all was found between image quality scores and patient dose (DLP).

Humans↗
PubMed2003

Pulsed electric fields cause sublethal injury in Escherichia coli.

AIMS: The objective was to investigate the occurrence of sublethal injury in Escherichia coli by pulsed electric fields (PEF) at different pH values. METHODS AND RESULTS: The occurrence of sublethal injury in PEF-treated E. coli cells depended on the pH of the treatment medium. Whereas a slight sublethal injury was detected at pH 7, 99.95% of survivors were injured when cells were treated at pH 4 for 400 micros at 19 kV. The PEF-injured cells were progressively inactivated by a subsequent holding at pH 4. CONCLUSIONS: PEF cause sublethal injury in E. coli. The measurement of sublethal injury using a selective medium plating technique allowed prediction of the number of cells that would be inactivated by subsequent storage in acidic conditions. SIGNIFICANCE AND IMPACT OF THE STUDY: This work could be useful for improving food preservation by PEF technology and contributes to the knowledge of the mechanism of microbial inactivation by PEF.

Colony Count, Microbial↗
PubMed2002

Pituitary-thyroid axis, thyroid volume and leptin in healthy adults.

OBJECTIVE: Patients with thyroid diseases usually have disturbances relating to body weight and thermogenesis. On the other hand, leptin is involved in the regulation of body weight, food intake and thermogenesis. Some studies have investigated the relationship between leptin and dysthyroid states, but the complex interactions between leptin and pituitary-thyroid axis have led to controversial results. DESIGN: The aims of this cross-sectional study were to investigate the relationship among basal TSH, ultrasonographic thyroid volume and leptin in a group of 268 healthy adults randomly selected from our city, L'Hospitalet de Llobregat, Barcelona, an area free of iodine deficiency. In this euthyroid group, we determined basal TSH, thyroid autoantibodies, leptin concentrations, and thyroid volume by ultrasonography, body anthropometry, and body composition. RESULTS: All subjects were free of goitre and were negative for anti-thyroid antibodies. Basal TSH concentrations were 1.49 +/- 0.8 mU/l in males and 1.67 +/- 0.83 mU/l in females (p = 0.6). Anti-thyroid antibodies were negative in all cases; leptin concentrations were 6.1 +/- 4 ng/ml in males and 16.8 +/- 11.7 ng/ml in females (p = 0.0001). Thyroid volume was 9.8 +/- 4.6 ml in males and 6.5 +/- 2 ml in females (p = 0.001). There were significant correlations among leptin concentrations and anthropometric and body composition variables in both sexes, without correlation with TSH concentrations. There was no significant correlation between anthropometric and body composition variables and thyroid volume in males but there was a correlation in females. In females, there was a positive correlation between leptin and thyroid volume (r = 0.181, p = 0.038). In males, there was a negative correlation between TSH concentrations and thyroid volume (r = - 0.271, p = 0.002). CONCLUSIONS: We did not find any correlation between leptin levels and pituitary-thyroid axis in this control population. The correlation between leptin and thyroid volume in females is probably a consequence that leptin and thyroid volume are regulated in parallel by variables relating to anthropometry and body composition.

Adult↗
PubMed2000

Oral immunogenicity of the plant derived spike protein from swine-transmissible gastroenteritis coronavirus.

Transgenic plants represent an inexpensive alternative to classical fermentation systems for production of recombinant subunit vaccines. Transgenic potato plants were created that express the N-terminal domain of the glycoprotein S (N-gS) from Transmissible gastroenteritis coronavirus (TGEV), containing the major antigenic sites of the protein. Extracts from potato tubers expressing N-gS were inoculated intraperitoneally to mice, and the vaccinated mice developed serum IgG specific for TGEV. Furthermore, when potato tubers expressing N-gS were fed directly to mice, they developed serum antibodies specific for gS protein, demonstrating the oral immunogenicity of the plant derived spike protein from TGEV.

Administration, Oral↗
PubMed2000

Liver xenotransplantation: changes in lipid and lipoprotein concentration after long-term graft survival.

BACKGROUND/AIMS: Today, scientists devote considerable effort to the study of mechanisms of xenograft rejection, but with liver xenotransplantation (XTx) researchers face the added problem of metabolic incompatibility between species. To date, there have been few studies of molecular xenogeneic interactions, perhaps because little progress has been made in solving immunological problems. This study is an initial analysis of lipoprotein metabolism in a hamster-to-rat hepatic xenotransplantation model. METHODS: There were 6 experimental groups (n=8): (1) male Sprague-Dawley (S.D.) rats (220-280 g); (2) male Golden Syrian hamsters (100-150 g); (3) S.D. rats, "sham" operation with immunosuppression; (4) S.D. rat-to-S.D. rat alloTx; (5) S.D. rat-to-S.D. rat alloTx with immunosuppression; (6) XTx hamster G.S-to-S.D. rat with immunosuppression. Mofetil mycophenolate (25 mg/kg/d) was administered for 14 days and FK506 (0.2 mg/kg/d) for 45 days (groups 3, 5 and 6). After 24 h fasting, animals were sacrificed (day +50 postransplantation) and a complete lipoprotein profile was determined. Serum lipoproteins were subfractioned by ultracentrifugation in density gradient. RESULTS: There was a large increase in serum lipid levels in xenografted rats compared with control rats and allografted rats. Xenografted rats presented a severely altered lipoprotein profile compared with normal rats. Surprisingly, the characterisation of lipoproteins in xenografted rats displayed the same composition as donor animals. Histological study did not show signs of alteration of the hepatic architecture. CONCLUSIONS: Since the liver is the main solid organ co-ordinator of metabolic pathways, such as lipid metabolism, hepatic xenotransplantation makes changes in lipid concentrations in the recipient and also changes in lipid compositions of lipoproteins. Hepatic xenotransplantation is not a feasible solution given the organ's metabolic complexity.

Animals↗
PubMed2000

Effects of long-term treatment with GH in the bone mineral density of adults with hypopituitarism and GH deficiency and after discontinuation of GH replacement.

BACKGROUND: Only few previous studies have assessed the effects of long-term growth hormone (GH) replacement therapy on bone mineral density (BMD) in adult patients with GH deficiency. The aim of this study was to investigate the effects of long-term GH therapy on bone metabolism and BMD. MATERIAL AND METHODS: At the start of the study, 20 adults with GH deficiency were randomized to receive either GH, 0.25 IU x kg per week, or placebo. After 6 months, patients in the placebo group were switched to GH therapy, and they received GH for a further 18 months. Of the 20 patients, 14 were male and 6 female with GH deficiency of adult-onset. The mean age of the patients at the start of the study was 40.3+/-10.9 years and the duration of GH deficiency was 10.6+/-6.4 years. Patients deficient in pituitary hormones other than GH had been receiving stable replacement doses of appropriate hormones for at least 6 months before the start of the study. Rates of bone metabolism were assessed by measuring calcium, phosphate, alkaline phosphatase, calciuria, phosphaturia and osteocalcin. BMD was measured by dual X-ray absorptiometry. Body composition was calculated from measurements of bioelectrical impedance. RESULTS: Before GH treatment, BMD in the femoral neck was lower in patients than in controls. The rate of bone resorption markers increased significantly after 6 months and remained stable during the whole treatment period. BMD significantly increased in L2-L4 after 12 months of treatment with an increase of Z-score. The total BMD increase was 4.5+/-6.5%. BMD in the femoral neck increased after 12 months with an increase of Z-score after 18 months. The total increase was 10.4+/-18%. The total BMD increase was not different among patients with or without basal osteopenia. In both groups BMD in L2-L4 and in the femoral neck remained stable after 12 months without GH treatment. Sex, age, BMI and the time in which GH deficiency started, before or after the end of the peak of BMD, did not correlate with BMD. The BMD values and their response to GH treatment did not correlate with other associated deficiencies, and we did not find differences among BMD increase and GH dose, levels of insulin-growth factor-I, insulin growth factor binding protein-3, and parameters of body composition. CONCLUSIONS: The results of the study support previous ones that BMD is subnormal in adults with GH deficiency; that GH replacement therapy stimulates bone turnover with initial biochemical changes; and that in the long term, this stimulation results in a significant augmentation in BMD that continues to increase after 2 years and remains stable after 12 months of GH withdrawal.

Absorptiometry, Photon↗
PubMed2000

Determinants of thyroid volume as measured by ultrasonography in healthy adults randomly selected.

OBJECTIVES: The relationship between thyroid volume and anthropometric characteristics is a matter of controversy. The aim of this study was to investigate thyroid volume and its determinants in healthy adult subjects from a noniodine-deficient area. DESIGN AND PATIENTS: Of the 280 000 inhabitants of the city, served by L'Hospitalet de Llobregat, we randomly selected 880 subjects from the census of the city. The participation rate in the study was 44%; after application of several exclusion criteria, a further 28 subjects were excluded because of previously diagnosed thyroid disease. We finally studied 268 subjects representative of the census of the city: 134 male and 134 female, without thyroid disease. We determined the anthropometric characteristics, body mass index, waist-hip ratio, body surface area; body composition by bioelectrical impedance analyser; thyroid volume by ultrasonography; basal TSH, antithyroid antibodies and urinary iodine excretion. RESULTS: Thyroid volume in our population was higher in males (9.19 ml, CI 9.09-10.65) than in females (6.19 ml, CI 6.02-6.92), P = 0.001. Significant correlations were found among thyroid volume and body weight (r = 0.39, P = 0.0001), height (r = 0.44, P = 0.0001), body mass index (r = 0.13, P = 0.02), waist-hip ratio (r = 0.38, P = 0.0001), body surface area (r = 0.48, P = 0.0001), total body water (r = 0.14, P = 0.02), free fat mass (r = 0.47, P = 0.0001), fat mass (r = 0.37, P = 0.001) and body fat (r = 0.32, P = 0.001). Negative correlation was found between thyroid volume and basal TSH (r = -0.26, P = 0.001). No correlations were found among thyroid volume and iodine excretion, previous pregnancies in women, cigarette smoking and alcohol consumption. In a multiple regression analysis with thyroid volume as the dependent variable, body surface area was demonstrated to account for the 44% of variation of thyroid volume (P = 0.0001). CONCLUSION: It is important to know the reference values of the thyroid volume in a population free of iodine deficiency and its determinants. Body surface area accounts for much of the variation of thyroid volume. Age, gender, anthropometric variables, body composition variables and biological variables, do not significantly influence the thyroid volume when considered as possible additions to this baseline model.

Adult↗
PubMed2000

Trk1 and Trk2 define the major K(+) transport system in fission yeast.

The trk1(+) gene has been proposed as a component of the K(+) influx system in the fission yeast Schizosaccharomyces pombe. Previous work from our laboratories revealed that trk1 mutants do not show significantly altered content or influx of K(+), although they are more sensitive to Na(+). Genome database searches revealed that S. pombe encodes a putative gene (designated here trk2(+)) that shows significant identity to trk1(+). We have analyzed the characteristics of potassium influx in S. pombe by using trk1 trk2 mutants. Unlike budding yeast, fission yeast displays a biphasic transport kinetics. trk2 mutants do not show altered K(+) transport and exhibit only a slightly reduced Na(+) tolerance. However, trk1 trk2 double mutants fail to grow at low K(+) concentrations and show a dramatic decrease in Rb(+) influx, as a result of loss of the high-affinity transport component. Furthermore, trk1 trk2 cells are very sensitive to Na(+), as would be expected for a strain showing defective potassium transport. When trk1 trk2 cells are maintained in K(+)-free medium, the potassium content remains higher than that of the wild type or trk single mutants. In addition, the trk1 trk2 strain displays increased sensitivity to hygromycin B. These results are consistent with a hyperpolarized state of the plasma membrane. An additional phenotype of cells lacking both Trk components is a failure to grow at acidic pH. In conclusion, the Trk1 and Trk2 proteins define the major K(+) transport system in fission yeast, and in contrast to what is known for budding yeast, the presence of any of these two proteins is sufficient to allow growth at normal potassium levels.

Amino Acid Sequence↗
PubMed2000

Hypothyroidism after iodine-131 or surgical therapy for Graves' disease hyperthyroidism.

BACKGROUND: The aim of this work was to describe late permanent hypothyroidism after iodine-131 or surgery, and to seek predictive factors of hypothyroidism for the two treatments. MATERIAL: From 1979 to 1994, 462 patients with Graves' disease hyperthyroidism underwent definitive treatment. Three hundred and fifty-five patients were treated with low calculated doses of iodine-131, and 107 patients with subtotal thyroidectomy. Life-table analysis was performed and the cumulative incidence of hypothyroidism was calculated by Kaplan-Meier's method, and survival (euthyroidism) within the groups was compared by the Mantel-Cox method. RESULTS: Of the 355 patients treated with one dose of 6.6 1.9 mCi of iodine-131, 246 became euthyroid after one dose, and 109 needed 2 or more doses. Twenty-two patients received one or more doses higher than 10 mCi. The probability of euthyroidism at 145 months after low-dose was 10. 19% and age, sex, pretreatment with antithyroid drugs, previous subtotal surgery did not influence the final outcome. Of the 107 surgically treated patients the probability of euthyroidism at 144 months was 56.1%. Age, sex, duration of hyperthyroidism, duration of antithyroid treatment, weight of thyroid resected, did not influence the final outcome. The weight of the thyroid remnant was 5.4 1.5 g and the multivariate statistical model by conditional logistic regression showed that the weight of thyroid remnant was the only variable that influenced long-term thyroid function. CONCLUSIONS: There is no ideal dose of iodine-131 that would correct hyperthyroidism in Graveś disease without risk of hypothyroidism. Surgery is an alternative definitive treatment with a risk of hypothyroidism within the 2 first years, and a cumulative risk of hypothyroidism lower than with iodine-131.

Adult↗