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At least 19 recordsLinked to original sources

Apathetic hyperthroidism.

Among the psychosyndromes least well known to be associated with an endocrinopathy is apathetic hyperthyroidism. This condition is characterized by apathy, lethargy, severe "senile depression" and often a high output cardiac failure occurring as the presenting problem.1,2,9 The depressive component of the clinical picture may occur without cardiac complications. Such depressions in the elderly, while refractory to treatment with antidepressant drugs, often respond dramatically to the correction of the underlying endocrine dysfunction.4 It is therefore important to consider "thyroid melancholia" in the differential diagnosis of such cases. Given this high index of suspicion, the diagnosis can be fairly easily made.

Aged↗

Highly sensitive assays of serum-thyrotropin in the diagnosis of hyperthyroidism: assessment of performance and reference values.

The performance of three different highly sensitive immuno-assays for thyrotropin in serum (S-TSH) was compared. Specimens from 803 patients with suspected hyperthroidism or other thyroid disease were used. Hyperthyroid patients were identified and characterized by determining serum thyroid hormones and by clinical observation. The performance of the methods in discriminating between hyperthyroidism and euthyroidism was described in terms of diagnostic sensitivity and specificity. The performance was also assessed by systematically varying the reference values. If patients with treated hyperthroidism were eliminated, the three S-TSH assays performed equally well at a suggested lower reference value of 0.4 mU/l. A diagnostic efficiency of more than 0.95 was achieved at the observed prevalence of disease (0.12). A graphical model which allows an adjustment of reference values to favour sensitivity or specificity is presented. Reference values were also calculated from the euthyroid subjects using parametric and non-parametric approaches. The specificity, when using the recommended discrimination level, suggests that patients with low S-TSH values should be subjected to further investigation by biochemical or other methods.

Adolescent↗

Thyroid imaging with iodine-125 and technetium-99m.

Eighty-eight patients referred consecutively for thyroid imaging were studied. Each patient was scanned with a 3'' rectilinear scanner using both 125I and 99mTc. The paired scans were evaluated independently by two physicians experienced in thyroid evaluation and image analysis. The images were ranked on a scale from 1 to 5 as follows: 1) 125I scan much better than the 99mTc scan, 2) ..., 3) 125I scan and 99mTc scan the same, 4) ..., 5) 99mTc scan much better than 125I scan. The scores were statistically analyzed by the sign test and transformed normal score methods. Categories analyzed were: A. Hypothyroid, B. Euthyroid, C. Hyperthroid, (A-C based upon RAIU measurements), D. Cold Nodules, E. Graves Disease, F. Hot-Nodules, G. Multinodular Nontoxic Goiter, H. Miscellaneous and I. Normal. The significance of this study is that regardless of the classification we used, in no category was the 99mTc scan considered better than the 125I scan. This finding is at variance with the observations of some others comparing 99mTc with other iodine radioisotopes. 99mTc may have some procedural advantages and does deliver a lower radidation dose to the thyroid.

Adult↗