RESUMO
To verify the effect of piroxicam-beta-cyclodextrin (P-B-CD), a novel non-steroidal anti-inflammatory compound, on regional cerebral blood flow (rCBF) during migraine attacks, 7 female patients (mean age: 37.4 years), suffering from migraine without aura, were studied. The patients, after induction of a migraine-like attack with sublingual nitroglycerin (NTG), underwent a rCBF evaluation using Single Photon Emission Computerized Tomography (SPECT) and Tc-99m examethyl-propylene-amino-oxyma split-dose method before and after oral administration of P-B-CD (20 mg). In addition, a spontaneous migraine attack and NTG test in 7 control subjects were investigated. All patients observed relief of pain, evaluated by direct and indirect parameters (Pain Intensity; Pain Intensity Difference; Sum of Pain Intensity Difference). SPECT revealed a uniform and symmetrical distribution of the radiocompound in 5 out of 8 patients, while in the remaining 3 symmetrical parietal or parieto-occipital areas of decreased tracer uptake were detected. In these cases, the intake of P-B-CD cancelled out the cerebral perfusion abnormality.
Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Encéfalo/irrigação sanguínea , Ciclodextrinas/uso terapêutico , Transtornos de Enxaqueca/tratamento farmacológico , Piroxicam/uso terapêutico , Tomografia Computadorizada de Emissão de Fóton Único , beta-Ciclodextrinas , Adolescente , Adulto , Velocidade do Fluxo Sanguíneo/efeitos dos fármacos , Combinação de Medicamentos , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos de Enxaqueca/diagnóstico por imagem , Nitroglicerina , Compostos de Organotecnécio , Oximas , Medição da Dor , Fluxo Sanguíneo Regional/efeitos dos fármacos , Tecnécio Tc 99m ExametazimaRESUMO
Surgical treatment of multinodular goiter is still now discussed: total versus subtotal thyroidectomy. Advantages of partial thyroidectomy are the low incidence of laryngeal nerve injury and the low risk of hypoparathyroidism. Disadvantages are the increased recurrent disease, the risk of carcinoma, the elevated possibility of laryngeal nerve lesions and permanent hypoparathyroidism after reoperations. Own experience regarding 401 thyroid operations is reported; 60 patients were operated for multinodular goiter; 48 subtotal and 12 total thyroidectomy were performed. Among those 1 (1.65%) inferior laryngeal lesion and 1 (1.65%) permanent hypoparathyroidism occurred. Anatomic knowledge and correct surgical procedure give a reduction in the mobility of total thyroidectomy which in selective case can be considered the treatment of choice.
