[Diabetes mellitus associated with atypical antipsychotic medications: case report and review of the literature].

Since the introduction of atypical antipsychotic medications, starting with clozapine in 1990, many studies have associated these drugs with the development of diabetes among other metabolic disorders, as well as with the onset of the disease as ketoacidosis. We report the case of a 28-year-old patient with schizophrenia who was admitted with diabetic acidosis 1 month after the beginning of clozapine therapy. No weight gain was reported and the patient maintains satisfactory glycemia levels with no treatment required after discontinuation of the drug.

Malformations in the offspring of women with thyroid cancer treated with radioiodine for the ablation of thyroid remnants.

Rationale: Since ovarian function is only temporarily compromised by radioiodine therapy, many women with thyroid cancer treated with radioiodine can become pregnant. The present study evaluated the evolution of these pregnancies and the consequences for the offspring.

Patients And Methods: We retrospectively analyzed 78 pregnancies of 66 women submitted to total thyroidectomy, followed by radioiodine therapy 3.

[Follow-up of high-risk patients with differentiated thyroid cancer without persistent disease after initial therapy].

This study evaluated the follow-up of high-risk patients with thyroid cancer after initial therapy. A total of 125 high-risk patients (tumor >4 cm and/or extrathyroid invasion and/or lymph node metastases, and age >45 years), with complete resection of the tumor, were selected. All patients underwent total thyroidectomy and ablation with (131)I[3.

Managing thyroid cancer without thyroxine withdrawal.

Thyroxine (T4) withdrawal or recombinant TSH is used for the stimulation of thyroglobulin (Tg), whole-body scanning (WBS) and iodine-131 treatment in patients with thyroid carcinoma. This study evaluated the T4 dose reduction protocol as an alternative for patients' preparation. Fifty-one patients were submitted to total T4 withdrawal for WBS and Tg measurement.

[Recombinant TSH in ablative therapy and follow-up of patients with differentiated thyroid carcinoma].

The studies evaluating the efficacy and safety of recombinant TSH in the ablative therapy and follow-up of patients with differentiated thyroid carcinoma by serum thyroglobulin (Tg) measurement and iodine scanning were reviewed in this article. Recombinant TSH is comparable to hypothyroidism in the generation of Tg and in the execution of iodine-131 whole-body scanning, with the advantage of sparing patients from the symptoms of hypothyroidism and from impaired quality of life induced by levothyroxine withdrawal, in addition to a reduced exposure to elevated TSH and shorter absence from work, with recombinant TSH being the preparation indicated for the diagnosis of metastases in both low risk (Tg after recombinant TSH) and moderate or high risk patients (Tg and iodine-131 scanning after recombinant TSH). In the case of ablative therapy, the results are promising when using a dose of 100 mCi for remnant ablation, but hypothyroidism is still preferred, except for patients in whom the desired TSH elevation after levothyroxine withdrawal is not achieved, patients with base diseases that are aggravated by acute and severe hypothyroidism (severe heart and lung disease, coronary disease, compromised renal function, history of psychosis due to myxedema), patients debilitated by advanced disease, and elderly individuals.

[Clinical manifestations and diagnosis of distant metastases of differentiated thyroid carcinoma after initial therapy].

We studied 58 patients with distant metastases of differentiated thyroid carcinoma diagnosed after initial therapy. Lymph node metastases were observed in 65% of the patients on initial presentation. All lymph node metastases, ninety percent of the lung metastases and only 25% of the bone metastases were asymptomatic.

[Treatment of papillary microcarcinoma of the thyroid].

We retrospectively analyzed the recurrence, distant metastases and mortality of 78 patients with papillary microcarcinoma during a mean period of 6.8 years. None of the 56 patients with unifocal tumors without metastases relapsed, irrespective of the type of treatment (22 submitted to lobectomy, 11 to total thyroidectomy without ablation and 23 with ablation).