The Value of Serum Thyreoglobulin Levels and Whole Body (I-131) Scintigraphy in the Follow-Up of the Thyroid Cancer Patients after Thyroidectomy

Serum thyreoglobulin (Tg) and whole body scintigraphy (I-131 WBS) have been used to detect recurrent and metastatic thyroid cancers postoperatively. However, discordant results of Tg measurement and 131I WBS have been reported. Negative 131IWBS and a positive Tg test are usually found, but less common occurrence of positive 131IWBS and a negative Tg test has also been demonstrated in a small but significant number of cases. Therefore, the aim of the study was to retrospectively analyse patients with positive 131I WBS after total thyreoidectomy and again 1 year after the radioactive iodine. There were 52 patients included in the study. Four weeks after surgery, during which thyroid hormone treatment was not introduced, each patient received an ablative dose of 131I. The evaluation of the WBS was qualitative and considered positive if thyroid remnant, lymphatic node or metastasis were detected. WBS and serum Tg was measured 12 months after 131I ablation with thyroid hormone suppression. We considered positive any Tg level above the sensitivity values and negative if lower than this level. Tg levels were related to the existence of a positive scan or a negative one. In our 52 WBS positive patients concordant positive Tg levels were observed in 42 patients while in 10 patients we found a negative Tg levels after the surgery. After 1-year follow-up, out of initially 42 concordant patients 8 patients showed remaining concordant positive Tg and WBS values. Discordant results were observed in 13 patients (4 patients were Tgand WBS+ while 9 patients were Tg+ and WBS-). In the majority of patients (50%) remained with concordant results but changed from Tg+ and WBS+ to Tg- and WBS-. Diagnostic WBS is an additional valuable tool, besides Tg levels, in the follow up of patients after total thyreoidectomy

Importance of Measurement of Thyroglobulin and Anti-Thyroglobulin Antibodies in Differentiated Thyroid Cancer

Differentiated thyroid cancers include papillary and follicular carcinomas, both originating from follicular epithelium. Treatment of choice is usually total or near total thyroidectomy, followed by ablative radioiodine 131I treatment, and by the long term administration of thyroid hormone. Despite its excellent prognosis, recurrent disease does occur in approximately 20–40% of patients. Guidelines for the follow-up management of differentiated thyroid cancer are commonly based on circulating thyrogobulin measurement in the complete absence of eutopic thyroid tissue. A retrospective review was conducted on 116 patients (66 papillary and 50 follicular carcinoma, mean age 51.2 years) who had undergone total or near total thyroidectomy and radioactive iodine remnant ablation. Serum thyroglobulin (Tg) and anti-thyroglobulin antibodies (TgAb) levels were measured preoperatively, 1 month after thyroidectomy (before 131I treatment) and 6 and 12 months after ablation therapy (Tg1, TgAb1 and Tg2, TgAb2, respectively). During one year of follow-up, in a total of 24 patients (21%) recurrent disease were confirmed by ultrasonography and whole-body-scanning, mostly. It was found significant correlation between serum Tg levels (measured preoperatively and postoperatively) and recurrent diseases (p<0.05), while serum TgAb levels did not have any statistical significance. However, in multivariate regression analysis only Tg levels measured 12 months after the therapy (Tg2) remained a significant predictor of recurrent disease (p=0.008). Although a high Tg level before surgery does not indicate that tumor is present, in the postoperative period and after ablative therapy Tg has proven predictive value because stimulated Tg levels above 10ng/ml confirmed that indicate residual or recurrent cancer, and its periodically measurements is recommended

Azythromicin Versus Amoxicillin-clavulanate in the Treatment of Acute Sinusitis in Children

In this prospective study we compared the efficiency of azithromycin and amoxicillin-clavulanate in treatment of acute sinusitis in children. Seventy patients were included in the age between 5 and 15 years. Beside ENT and pediatricians examination, nasal and throat smear on culture and antibiogram is taken from all the patients, as well as, X-ray of paranasal sinuses and laboratory findings, followed by check-up of nasal and throat smear and X-ray of paranasal sinuses. Azithromycin in single daily dose of 10 mg/kg during three days showed same efficiency as amoxicillin-clavulanate given three times per day in dose of 45 mg/kg during ten days

Azythromicin Versus Amoxicillin-clavulanate in the Treatment of Acute Sinusitis in Children

In this prospective study we compared the efficiency of azithromycin and amoxicillin-clavulanate in treatment of acute sinusitis in children. Seventy patients were included in the age between 5 and 15 years. Beside ENT and pediatricians examination, nasal and throat smear on culture and antibiogram is taken from all the patients, as well as, X-ray of paranasal sinuses and laboratory findings, followed by check-up of nasal and throat smear and X-ray of paranasal sinuses. Azithromycin in single daily dose of 10 mg/kg during three days showed same efficiency as amoxicillin-clavulanate given three times per day in dose of 45 mg/kg during ten days

Incidence of malignant tumors of larynx and their treatment

We retrospectively analyzed patients with larynx cancer that were treated at ENT Clinics in Sarajevo in the last 5 years. According to the tumor site, TNM classification, operative procedure and postoperative treatment we found the following: Over the last 5 years 156 patients underwent surgical treatment--143 (91,6%) male and 23 (8.4%) female. According to the age 1 patient belonged in the age group 30-40 years (0.64%), 25 in the age group 40-50 years (16%), 51 in the age group 50-60 (32.7%), and 79 were over 60 years of age (50.6%). Of those 145 were smokers (93%), and 11 non-smokers (7%). Histological findings showed 100% cases with squamous cell cancer. Most of the patients were surgically treated with total laryngeoctomy with unilateral or bilateral dissection and thyroidectomy or lobectomy (29%) or total laryngectomy with thyroidectomy or lobectomy (23%), total laryngectomy (22%). The rest of the patients underwent total laryngeoctomy with unilateral or bilateral dissection (16%) chordectomy (4%), supraglottic laryngectomy (3%), hemilaryngectomy (2%) and hemilaryngectomy with dissection (1%) All patients were postoperatively irradiated and chemotherapy was combined with irradiation only in younger patients

Incidence of malignant tumors of larynx and their treatment

We retrospectively analyzed patients with larynx cancer that were treated at ENT Clinics in Sarajevo in the last 5 years. According to the tumor site, TNM classification, operative procedure and postoperative treatment we found the following: Over the last 5 years 156 patients underwent surgical treatment--143 (91,6%) male and 23 (8.4%) female. According to the age 1 patient belonged in the age group 30-40 years (0.64%), 25 in the age group 40-50 years (16%), 51 in the age group 50-60 (32.7%), and 79 were over 60 years of age (50.6%). Of those 145 were smokers (93%), and 11 non-smokers (7%). Histological findings showed 100% cases with squamous cell cancer. Most of the patients were surgically treated with total laryngeoctomy with unilateral or bilateral dissection and thyroidectomy or lobectomy (29%) or total laryngectomy with thyroidectomy or lobectomy (23%), total laryngectomy (22%). The rest of the patients underwent total laryngeoctomy with unilateral or bilateral dissection (16%) chordectomy (4%), supraglottic laryngectomy (3%), hemilaryngectomy (2%) and hemilaryngectomy with dissection (1%) All patients were postoperatively irradiated and chemotherapy was combined with irradiation only in younger patients