A leishmaniose tegumentar americana (LTA) é uma doença infecciosa, não contagiosa de pele e mucosas, causada por protozoários do gênero Leishmania 2 4 11 . É uma infecção zoonótica que afeta vários animais silvestres e domésticos, tendo o homem como hospedeiro secundário 4 11 . A transmissão habitual se dá através da picada de insetos das várias espécies de flebotomíneos, dependendo da localização

Graves' disease, as known today, is an autoimmune, diffuse, chronic disease of thyroid gland, as described by Robert Graves in 1835. It presents genetic predisposition and unknown etiology evidence, which is influenced in its development by several factors, including environment (dietary iodine intake, stress, drugs and infections). The disease is characterized by one or more changes: hyperthyroidism, goiter, ophthalmopathy, skin changes and pretibial myxedema, around 5% less common, and other symptoms 90% to 95%. One of the most relevant clinical practice aspects in Graves' disease patients management is to distinguish Graves' disease in initial phase, from other types of destructive thyrotoxicosis, in addition to evaluate therapeutic methods and efficient follow up, as well as predict early recurrence or remission of disease. Scintigraphy with pertechnetate (99 mTc) and TSH levels dosage are considered the choice for this purpose. However, they present some technical difficulties, as they are not widely available and have contraindications. In this scenario, thyroid color-flow doppler ultrasonography (US Doppler) presents a viable alternative, as a widely available, low cost, non-invasive and radiation free method, providing initial diagnosis and patients with Graves' disease follow up. In adittion, this method is used in differential diagnosis with other causes of thyrotoxicosis in the early stage.

Purpose The objective of this study was to prove the efficacy of Doppler ultrasonography (US-Doppler) in the follow-up of patients with GD treated with radioactive iodine. Methods 97 patients (77 female and 20 male) with a mean age of 42 years (SD ± 15) and with prior diagnosis of GD were treated with radioiodine. In total, 88.5 % achieved euthyroidism or hypothyroidism after treatment. The study was documented before treatment and one, three, and six months after treatment with radioactive iodine (131I) by a single investigator. The volume, echogenicity, echotexture and vascularization of the glands as well as the peak systolic velocity (PSV) of the inferior thyroid arteries were evaluated and compared with the laboratory data. Results Thyroid volume and PSV had a statistically significant correlation with hormone levels (p < 0.05). The mean pre-dose therapeutic thyroid volume was 43.01 ± 3.88 cm3 and was 11.58 ± 11.26 cm3 6 months after treatment. The mean PSV before 131I was 90.06 ± 44.13 cm/s and decreased significantly over time (p < 0.001). Six months after the therapeutic dose, the mean PSV was 32.95 ± 16.36 cm/s. However, the subjective parameters did not have a significant correlation with the normalization of the thyroid hormones. Conclusion Doppler US was useful for monitoring the therapeutic response of GD patients after treatment with radioiodine by evaluating the thyroid volume and peak systolic velocity.

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