PubMed · 8312117
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B Giantonio, R F Ozols, G R Hudes. 1993. Genitourinary malignancy.. https://pubmed.ncbi.nlm.nih.gov/8312117/
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PURPOSE: The dose of radioactive iodine ((131)I) required to ablate thyroid remnants following surgery for differentiated thyroid carcinoma is controversial. Typical administered activities range from less than 30 mCi up to 100 mCi, reflecting local practice and regulations governing allowable outpatient doses. This review examines the available randomized trials designed to assess the optimal ablative dose in this setting. METHODS AND MATERIALS: The authors identified three such trials published in 1987, 1991, and 1996, and critically reviewed them from a scientific and statistical point of view. RESULTS: Two of these studies were small and lacked adequate statistical power to answer the question, and the third was very poorly conducted. CONCLUSION: In our opinion, the appropriate dose of (131)I for ablation of thyroid remnants remains undetermined.
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When a toxic newborn or young infant presents with fever and lethargy or irritability, it is important to consider the diagnosis of meningitis even if the classic localizing signs and symptoms are absent. Cerebrospinal fluid should be obtained (unless lumbar puncture is clinically contraindicated) to enable initial therapy to be planned. Initial results of cerebrospinal fluid testing may not conclusively differentiate between aseptic and bacterial meningitis, and antimicrobial therapy for all likely organisms should be instituted until definitive culture results are available. Comprehensive therapy, including antibacterial and antiviral agents, should continue until a cause is identified and more specific therapy is initiated, an etiology is excluded or the patient improves considerably and the course of antimicrobial therapy is completed. Group B streptococcus is the most common bacterial etiologic agent in cases of meningitis that occur during the first month after birth. Etiologies of aseptic meningitis include viral infection, partially treated bacterial meningitis, congenital infections, drug reactions, postvaccination complications, systemic diseases and malignancy. Long-term sequelae of meningitis include neuromuscular impairments, learning disabilities and hearing loss. Prompt diagnosis and treatment are essential to improved outcome.