Resultados de SPECT miocárdico y eventos cardiovasculares en dos servicios de Medicina nuclear de Bogotá durante 2011 a 2012 / Myocardial SPECT results and cardiovascular events in two nuclear medicine departments in Bogota from 2011 to 2012

Objective: This study sought to determine the relationship between the results obtained from myocardial SPECT with pharmacologic stress with dipyridamole and the development of major cardiovascular events in the follow-up of patients treated at two nuclear medicine departments in Bogota, Colombia. Materials and methods: 183 patients undergoing myocardial SPECT with pharmacological stress with dipyridamole between November 2011 and April 2012 with a twelve month follow-up, were included. The relationship between the development of major cardiovascular events and the functional or perfusion results of the myocardial SPECT were analyzed. Results: 14 patients from the 154 who completed the follow-up, developed cardiovascular events. Patients with abnormal studies had higher number of events (13 vs 1. p = 0.019) compared to those with normal studies. The results of abnormal perfusion were associated with higher incidence of events (15.19%). Conclusions: A normal myocardial SPECT study is related to reduced incidence of major cardiovascular events in a one year follow-up, even in patients with high-risk clinical characteristics.

Objective: This study sought to determine the relationship between the results obtained from myocardial SPECT with pharmacologic stress with dipyridamole and the development of major cardiovascular events in the follow-up of patients treated at two nuclear medicine departments in Bogota, Colombia. Materials and methods: 183 patients undergoing myocardial SPECT with pharmacological stress with dipyridamole between November 2011 and April 2012 with a twelve month follow-up, were included. The relationship between the development of major cardiovascular events and the functional or perfusion results of the myocardial SPECT were analyzed. Results: 14 patients from the 154 who completed the follow-up, developed cardiovascular events. Patients with abnormal studies had higher number of events (13 vs 1. p = 0.019) compared to those with normal studies. The results of abnormal perfusion were associated with higher incidence of events (15.19%). Conclusions: A normal myocardial SPECT study is related to reduced incidence of major cardiovascular events in a one year follow-up, even in patients with high-risk clinical characteristics.

Conversión a hipotiroidismo en tratamiento con I131 por hipertiroidismo secundario a enfermedad de Graves Hospital de San José, enero 2005 - diciembre 2008 / Time to development of hypothyroidism following I131 therapy for hyperthyroidism due to Graves disease San José Hospital, January 2005 - December 2008

El hipertiroidismo tiene alta prevalencia e incidencia en Colombia y requiere diagnóstico y tratamiento adecuados por los riesgos cardiovasculares y oftalmológicos que conlleva. Debido a los diferentes resultados el tiempo de conversión a hipotiroidismo pos administración de I131 hallados en la literatura, se realizó un estudio de cohorte retrospectiva en pacientes con enfermedad de Graves que recibieron I131 en los servicios de endocrinología, medicina interna y medicina nuclear del Hospital de San José, de enero de 2005 a diciembre de 2008. El objetivo principal fue establecer el tiempo mediano de conversión a hipotiroidismo y el secundario fue determinar si la edad tiene influencia. Se revisaron diez referencias bibliográficas, catorce revistas y tres textos guía. El análisis de sobrevida se basó en curvas de Kaplan-Meyer mediante el empleo del programa estadístico STATA 10; 89 historias clínicas cumplieron con los criterios de inclusión. El 76% de los pacientes con enfermedad de Graves manejados con I131 presentaron conversión a hipotiroidismo en los primeros seis meses, el resto en el curso de los seis meses siguientes con un pico a los nueve. El tiempo mediano fue de seis meses. La eficacia se registra a los seis meses y es un marcador de eficacia terapéutica para hipotiroidismo por enfermedad de Graves. Cuando no hay conversión, se recomienda el seguimiento estricto de los pacientes con el fin de elegir la terapéutica apropiada.

Hyperthyroidism has a high prevalence and incidence in Colombian population and requires diagnostic tools and adequate treatment for it carries risks for cardiovascular problems and ophthalmopathology. A retrospective cohort study was conducted due to the different results found in literature on the time at which hypothyroidism occurred following I131 therapy in patients with Graves Disease who received this treatment at the Endocrinology, Internal Medicine and Nuclear Medicine departments at the San José Hospital, from January, 2005 to December, 2008. The primary objective was to establish the median time to hypothyroidism development and the secondary objective was to determine if it is age-related. Ten bibliographic references were reviewed, 14 journals and three guide texts. The survival analysis was based on the Kaplan-Meier curves using the STATA 10 statistical program. Eighty-nine of the reviewed clinical records met the inclusion criteria. It was found that 76% of patients with Graves Disease who received I131 therapy developed hypothyroidism during the first six months and the remaining patients within the following six months with a peak at nine months. The median time to hypothyroidism development was six months. These findings allow us to state that therapy efficacy may be registered at six months and that it is a marker of therapeutic efficacy for hypothyroidism due to Graves Disease. A strict follow-up is recommended in patients in whom hypothyroidism does not occur in order to select the appropriate treatment regime.

Medicina nuclear en pediatría

En el presente artículo de revisión se describen las múltiples aplicaciones de los procedimientos isotópicos en el diagnóstico y seguimiento de diferentes entidades patológicas en el paciente pediátrico, haciendo además referencia a las técnicas de exámen, dosis administradas, ventajas y limitaciones de este importante método diagnóstico

Cistografía nuclear

Se hace una revisión de los estudios de cistografía nuclear practicados en el servicio en un período de 23 meses considerando tanto la parte técnica como los resultados, para determinar indicaciones, ventajas y desventajas de dicho método en el diagnóstico y seguimiento de pacientes con reflujo vesicoureteral