Annals of nuclear medicine
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Comparative Study Controlled Clinical Trial
Regional cerebral blood flow in Alzheimer's disease: comparison between short and long-term donepezil therapy.
Treatment with donepezil improves cognitive function of patients with Alzheimer's disease (AD) when compared to a placebo-controlled group. The purpose of this study was to investigate changes in regional cerebral blood flow (rCBF) of AD patients in short-term and long-term treatment with donepezil. ⋯ Relative rCBF significantly increased in the short-term donepezil therapy, while following the long-term therapy, rCBF decreased to the pre-treatment level.
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Thyroid storm is extremely rare. However, hyperthyroid patients with severe thyrotoxicosis are frequently not treated immediately with I-131 for fear of thyroid storm but are placed on thiouracil drugs for varying periods of time. We demonstrate herein that it is safe to treat these patients with 1-131, without pretreatment with thiouracil drugs, provided they do not have complicating intercurrent disease. Our definition of severe hyperthyroidism includes marked signs and symptoms of thyrotoxicosis, suppressed TSH, markedly elevated free T4 and/or free T3 and elevated radioactive iodine uptake (RAIU) (>30%) at 4 or 24 hours. Our diagnostic criteria for thyroid storm include two or more findings of fever (>38 degrees C, 100 degrees F), severe tachycardia, high pulse pressure, agitation with tremors, flushing, sweating, heart failure, nausea, vomiting, diarrhea, jaundice associated with high free T4 and/or free T3. ⋯ It is safe to administer I-131 to patients who are severely hyperthyroid without fear of thyroid storm, provided beta blockade drugs are used to control the signs and symptoms; patient education is also important. With these steps, 4-6 weeks of prior medical treatment may not be necessary.
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Comparative Study
Diagnostic accuracy of bone metastases detection in cancer patients: comparison between bone scintigraphy and whole-body FDG-PET.
18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has become widely available and an important oncological technique. To evaluate the influence of PET on detection of bone metastasis, we compared the diagnostic accuracy of PET and conventional bone scintigraphy (BS) in a variety of cancer patients. ⋯ Diagnostic accuracy of bone metastasis was comparable in PET and BS in the present study. In a usual clinical condition, limited FOV (from face to upper thigh) of PET scan may not be a major drawback in the detection of bone metastases because of the relatively low risk of solitary bone metastasis in skull bone and lower limbs.
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The aim of this study was to evaluate the potential contribution of Tc-99m-MIBI scintigraphy to the follow-up of patients with differentiated thyroid carcinoma, who had elevated Tg levels and negative I-131 whole-body scan results. ⋯ We concluded that Tc-99m-MIBI scan should be considered as a supplementary scintigraphic method for the follow-up of patients with high serum Tg levels and negative I-131 WBS results, and it can help clinicians in making the decision to treat these patients.