BACKGROUND: Clinical manifestations of thyroid dysfunction are variable. The UST Scoring Index for thyroid disorders, formulated in the 1990s to evaluate thyroid functional status, was based on total thyroid hormone levels and thyroidal iodine uptake. However, with the advent of newer and more sensitive tests, the recommendations and practice now dictate the use of thyrotropin (TSH) and free thyroxine (FT4) levels in the confirmation of thyroid dysfunction.
OBJECTIVE: To validate the UST Scoring Index for thyroid disorders using TSH and FT4.
METHODS/RESULTS: The UST Clinical Scoring Index was administered to 170 patients presenting for thyroid-relatedcomplaints. Thyroid function tests were then requested (TSH and Free T4) and they were classified according to biochemical status. We obtained the following: 43 hyperthyroid, 102 euthyroid and 25 hypothyroid subjects. The mean TSH for the 3 groups were 0.08, 1.28, and 41.50 uIU/mL respectively (NV 0.27-3.75.) Mean FT4 levels were 36.18, 18.33, and 8.43 pM/L respectively (NV 10.3-25.0.) The most frequent findings in the biochemically hyperthyroid group were thyroid enlargement (88%), easy tiredness (74%), palpitations (70%), and nervousness (65%); in the euthyroid group, easy tiredness (62%), thyroid enlargement (54%), palpitations (53%), and irritability (49%); in the hypothyroid group, easy tiredness (64%), exertional dyspnea (52%), weight gain (44%), and constipation (44%.) The UST scoring index for thyroid disorders has a sensitivity of 67%, specificity of 84%, and accuracy rate of 80 %, with AUC of 0.850 on ROC analysis for the detection ofhyperthyroidism. For detecting hypothyroidism, it has a sensitivity of 40%, specificity of 92%, and asccuracy rate of 85%, with AUC 0.7553 on ROC analysis.
CONCLUSION: The UST scoring index for thyroid disorders has good sensitivity, specificity and accuracy rate based on ROC when validated using TSH and FT4 for the detection of hyperthyroidism and hypothyroidism.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Biological Assay ; Anxiety ; Constipation ; Dyspnea ; Hyperthyroidism ; Hypothyroidism ; Iodine ; Thyroid Diseases ; Thyroid Function Tests ; Thyrotropin ; Thyroxine ; Weight Gain

This is a descriptive study to assess the safety and efficacy of 188 Rhenium-HDD-Lipiodol conjugate in treating patients with unresectable hepatocellular carcinoma. Eight patients with inoperable hepatocellular carcinoma with liver lesions ranging from 1.8 x 2.0 cm to 12.7 x 70 cm participated in the study. 188 Rhenium-HDD-Lipiodol conjugate was administered to the patients via femoral catheter based on the radioactivity that was eluted from the generator. Corresponding whole body scintigraphic images, which showed significant tracer uptake in the liver lesions, were obtained at 24, 48 and 72 hours after 188 Rhenium-HDD-lipiodol administration. Follow-up CT scans in six patients showed progressive disease in three patients and stable disease in three patients. Two patients had re-treatment due to progression of liver lesions. Follow-up scintigraphy after re-treatment showed decrease in tracer uptake in liver lesions on one patient, while the other showed diffuse tracer uptake. Post-ttherapy symptoms were minimal: mild to moderate epigastric pain in two, nausea and vomiting in one, while the rest are asymptomatic. Karnofsky performance status of patients three months after the therapy ranged from 20-90%. Two of the eight patients are still living at the time this paper was written. Radionuclide therapy aided in the prolongation of life and improvement of its quality for some patients. 188 Rhenium-HDD-Lipiodol radio conjugate provides promising results in treating inoperable hepatocellular carcinoma.
Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; CARCINOMA, HEPATOCELLULAR

INTRODUCTION:Radioactive iodine(I131) therapy is an established definitive treatment for Graves' hyperthyroidism.However,the optimal method of determining the radioiodine treatment dose remains controversial.
OBJECTIVE: To compare the efficacy of fixed dose versus  calculated  dose  regimen  in  the  treatment  of  Graves'  hyperthyroidism  among  Filipinos 
METHODOLOGY: Diagnosed   Graves'   disease   patients underwent  thyroid  ultrasound  to  estimate  thyroid  size. Patients  were  randomized  to  either  fixed  or  calculated dose  of  radioiodine  treatment.  For  fixed  dose  group,the  WHO  goiter  grading  was  utilized:  Grade   0   (5mCi),  Grade   1  (7mCi),  Grade2  (10mCi),  Grade  3  (15mCi).  For calculated  dose  group  the  following  formula  was  used:
                    Dose(mCi)= 160uCi/g thyroid x thyroid gland weight in grams x 100  /  24-hour RAIU(%)
Thyroid function test (TSH,FT4)  was monitored every  three  months  for  one  year. 
RESULTS: Of  the  60  patients  enrolled,  45  (fixed  dose;  n= 27,  calculated  dose;  n=  18)  completed  the  six  months follow-up  study.  Analysis  was  done  by  application  of  the  intention-to-treat  principle.  The  percentage  failure  rate  at  third  month  in  the  fixed  vs.  calculated  dose  group  was:  26  v.  28%  with  a  relative  risk  (RR)  value  of  0.93.  At  six  months  post-therapy,  there  was  a  noted  reduction  in  the  failure  rates  for  both  study  groups  (11  vs.  22%,  respectively),  with   a   further   reduction   in   the   relative   risk   value (0.67),  favoring  the  fixed  dose  group.
CONCLUSION: Fixed   dose   radioiodine   therapy   for Graves'   disease   is   observed   to   have   a   lower   risk   of   treatment   failure   (persistent   hyperthyroidism)   at   three  and  six  months  post-therapy  compared  to  the calculated  dose.

Human ; Male ; Female ; Middle Aged ; Adult ; Iodine Radioisotopes ; Iodine ; Intention To Treat Analysis ; Graves Disease ; Hyperthyroidism ; Goiter ; Thyroid Function Tests ; Treatment Failure

This paper aims to discuss the sequential use of rituximab and 90Yttrium-ibritumomab tiuxetan, a novel treatment approach in the management of refractory follicular non-Hodgkin's lymphoma. Radioimmunotherapy (RIT), which combines the benefits of targeted radiation therapy and monoclonal antibody, has significantly increased the response rate well in excess of 50%. This is explained by the inherent radiosensitive nature of lymphoma cells. We present a case of a 56-year-old male with refractory follicular lymphoma. The patient was referred for RIT, the first case in the Philippines. The patient was pretreated with two doses of rituximab followed by an intravenous infusion of 90Y-ibritumomab tiuxetan (Zevalin). Hematologic nadir was reached six weeks following administration of the radioimmunotherapy. During this time, the patient developed melena. Hematologic recovery was noted after three weeks. Re-evaluation with computed tomography three months after treatment showed significant reduction in the tumor bulk and resolution of lymphadenopathies. This report underscores the importance and evolving role of radioimmunotherapy in the management of refractory non-Hodgkin's lymphoma.

Human ; Male ; Middle Aged ; Antibodies, Monoclonal ; Infusions, Intravenous ; Lymphadenopathy ; Lymphoma, Follicular ; Lymphoma, Non-hodgkin ; Melena ; Philippines ; Radioimmunotherapy ; Rituximab ; Tomography ; Yttrium Radioisotopes