[Thyroid cancer revealed by a suppressive hot nodule]. / Cancer thyroïdien révélé par un nodule chaud extinctif.

We report the case of a 62-year old woman in euthyroidism who presented with a thyroid cancer located within a hot nodule. The nodule was partially extinctive, and the triiodothyronine test showed incomplete suppression. Fine needle cytology showed no malignant cells. Systematic lobectomy was performed, and the diagnosis of cancer was made at pathology. This rare situation does not mean that all non-toxic hot nodules must be removed, but if surgery is decided an extemporaneous histological examination is mandatory. Besides, such cases provide an additional argument in favour of surgery or treatment of toxic adenomas.

Thyroglobulin, thyrotropin and thyrotropin binding inhibiting immunoglobulins assayed at the withdrawal of antithyroid drug therapy as predictors of relapse of Graves' disease within one year.

"Sensitive" thyrotropin (TSH), thyroglobulin (TG) and even thyrotropin binding inhibiting immunoglobulins (TBII) assays are now widely available. The objective of the present study was to determine the most accurate of these three parameters to predict the relapse of Graves' disease during the year following treatment discontinuation and to evaluate whether the assay of three markers is able to improve the prediction. TSH, TG and TBII were measured in the sera of 67 Graves' disease patients after at least 12 months of medical treatment. In 52 patients, TBII had also been determined before the beginning of the medical treatment. Under treatment, all the patients were clinically and biologically euthyroid, but in 9 goitrous patients it was impossible to lower the doses of carbimazole without an immediate relapse. The TSH levels of these 9 patients were still low in all cases but one; TG and TBII levels were abnormal in all. In the other 58 patients, the treatment was discontinued; 22 relapsed within one year, more frequently when a goiter was present. The most reliable parameter for the prediction of relapse was found to be TBII, as its specificity was high (94.5%), although its sensitivity was poor (45%); TG was more sensitive (64%) but far less specific (57%); TSH and "initial" TBII appeared to be of a little interest. When TBII was elevated prior to the withdrawal of treatment, the determination of TG was useful: abnormal values of both TBII and TG were always associated with a relapse. When TBII testing was negative, the relapse risk fell to 0.26, and to 0.08 when three criteria were matched: no goiter, negative TBII, normal TG.

Clinical value of thyrotropin binding inhibiting immunoglobulins (TBII) assay in hyperthyroidism.

More than 500 sera were assayed for TBII under routine conditions using "Trak" assay in order to evaluate the sensitivity, specificity and prognostic interest of this determination in hyperthyroidism. The sensitivity for the diagnosis of Graves' disease was 83.5%, better in ophthalmopathic patients (93%) than in non ophthalmopathic patients (75%). The specificity was 99.4% with only one false positive in a hypothyroid patient. TBII level significantly decreases with carbimazole treatment except in patients who remain hyperthyroid. Determination of TBII before stopping carbimazole treatment or after surgery has a prognostic significance as a positive value indicates a relapse in almost all cases. Conversely, a fall of TBII to normal levels with treatment is insufficient to assess recovery. High levels are frequently observed after radioiodine therapy but do not indicate a poor prognosis.

[Development of human consumption of proteins in France during the past ten years (1965-1974)]. / Evolution de la consommation humaine de protéines en france au cours des dix dernières années (1965-1974).

A rapid development in the alimentary comportment has been primarily due to socioeconomic and physico-sensorial factors. Protein consumption by the French population has modified over the past years. Even though the average ration is high and stable, approximatly 100 grams per day, protein malnutrition still exists. Actually, 16 p. 100 of the aged population, with moderate revenue, consume less than 45 grams of protein per day. Vegetal protein consumption over the last ten years has dropped by 14 p. 100 from 41,7 grams to 35,8 grams of 36 p. 100 of the total. A decline in the consumption of tender wheat down 20 p. 100 in ten years, is responsible for this reduction. Animal proteins represent 64 p. 100 of the ration protein which is a 10 p. 100 increase. However, the milk ration has dropped radically by less than 50 p. 100 during this same ten year period. This is compensated by an increase in cheese consumption, up 25 p. 100 and meat being more often purchased also up 15 p. 100. In the French population the protein ration is high and contains an overabundance of animal proteins associated with a high degree of saturated animal fats. Further studies must be made to permit a more precise evaluation of these consequences on public health and related industries in the alimentary field.