Measurement of stimulated Tg combined with neck ultrasonography after total thyroidectomy may exclude the need for ablation in 56% of low-risk patients without TgAb (Tg <1 ng/mL) and permit the administration of an activity of 1.1 GBq ¹³¹I in another 34% with low Tg levels.

BackgroundStudies on diabetic foot and its complications involving a significant and representative sample of patients in South American countries are scarce. The main objective of this study was to acquire clinical and epidemiological data on a large cohort of diabetic patients from 19 centers from Brazil and focus on factors that could be associated with the risk of ulcer and amputation.MethodsThis study presents cross sectional, baseline results of the BRAZUPA Study. A total of 1455 patients were included. Parameters recorded included age, gender, ethnicity, diabetes and comorbidity-related records, previous ulcer or amputation, clinical symptomatic score, foot classification and microvascular complications.ResultsPatients with ulcer had longer disease duration (17.2 ± 9.9 vs. 13.2 ± 9.4 years; p < 0.001), and poorer glycemic control (HbA1c 9.23 ± 2.03 vs. 8.35 ± 1.99; p < 0.001). Independent risk factors for ulcer were male gender (OR 1.71; 95 % CI 1.2–3.7), smoking (OR 1.78; 95 % CI 1.09–2.89), neuroischemic foot (OR 20.34; 95 % CI 9.31–44.38), region of origin (higher risk for those from developed regions, OR 2.39; 95 % CI 1.47–3.87), presence of retinopathy (OR 1.68; 95 % CI 1.08–2.62) and absence of vibratory sensation (OR 7.95; 95 % CI 4.65–13.59). Risk factors for amputation were male gender (OR 2.12; 95 % CI 1.2–3.73), type 2 diabetes (OR 3.33; 95 % CI 1.01–11.1), foot at risk classification (higher risk for ischemic foot, OR 19.63; 95 % CI 3.43–112.5), hypertension (lower risk, OR 0.3; 95 % CI 0.14–0.63), region of origin (South/Southeast, OR 2.2; 95 % CI 1.1–4.42), previous history of ulcer (OR 9.66; 95 % CI 4.67–19.98) and altered vibratory sensation (OR 3.46; 95 % CI 1.64–7.33). There was no association between either outcome and ethnicity.ConclusionsUlcer and amputation rates were high. Age at presentation was low and patients with ulcer presented a higher prevalence of neuropathy compared to ischemic foot at risk. Ischemic disease was more associated with amputations. Ethnical differences were not of great importance in a miscegenated population.

Recently, it was proposed that some papillary thyroid carcinomas (PTC) will no longer be termed 'cancer' and are christened as 'noninvasive follicular thyroid neoplasm with papillary-like nuclear features' (NIFTP). As this is a recent definition, little information is available about NIFTP. The objective of this study was to report the frequency, ultrasonographic appearance, cytology result and long-term evolution of cases of NIFTP seen at our institution. We excluded tumours ≤1 cm. The sample consisted of 129 patients. Sixty-four patients were submitted to total thyroidectomy and 65 to lobectomy. These patients with NIFTP did not receive radioiodine. NIFTP corresponded to 15% of cases diagnosed as PTC >1 cm. An ultrasonographic appearance considered to be of low suspicion for malignancy was common in NIFTP (32.5%), whereas a highly suspicious appearance was uncommon (5%). NIFTP frequently exhibited indeterminate cytology (62%), while malignant cytology was uncommon (4%). The patients were followed up for 12-146 months (median 72 months) after surgery. None of the patients developed structural disease during follow-up. Comparing the concentrations of thyroglobulin (Tg) and anti-Tg antibodies (TgAb) obtained 6-12 months after surgery and in the last assessment, none of the patients exhibited an increase in these markers.

Low-risk patients with PTC who have stimulated Tg ≤1 ng/mL after thyroidectomy do not require ablation with (131)I.

We have demonstrated four novel mutations of the BSCL2 and AGPAT2 genes responsible for Berardinelli-Seip syndrome and Brunzell syndrome (AGPAT2-related syndrome).