Thyroid counting

We have been impressed with the favorable radiation safety aspects of the GO-LPO iodination technique. Since we have been using this technique, personnel monitoring for radiation contamination both by bioassay (thyroid counts) and by dosimeter readings have not been above background (NAB). 

Only one detector of the upper array is used for thyroid counting, the other two being removed from the array by disconnecting the signal cables. Normally the detector is placed centrally over the supine subject s thyroid gland at a distance of 14 cm. However, some of the subjects had such high activities that the detector needed to be raised to reduce the dead time to manageable levels. 

All subjects were measured in the whole-body counter in a supine position. The first count was a whole-body count with the detectors scanning over the subject. The counts were acquired in MCS mode simultaneously with the normal acquisition in an attempt to determine the location of (other than in the thyroid). The second count was a thyroid count where the subject remained supine, but also extended the neck to raise the thyroid gland above the clavicles. The results from the latter counts were used to determine the retention parameters. 

Criteria for diagnosis Five or more attacks fulfilling the above criteria are necessary for diagnosis Laboratory assessments that may be helpful in excluding medical comorbidities Complete blood cell count (CBC), chemistry panel, thyroid function tests, erythrocyte sedimentation rate (ESR)... 

Tests to exclude possible causes of dementia include a depression screen, vitamin B12 deficiency, thyroid function tests [thyroid-stimulating hormone (TSH) and free triiodothyronine and thyroxine], complete blood cell count, and chemistry panel.21... 

Perform urinalysis, urine toxicology, thyroid function, and white blood cell count in the elderly to rule out urinary tract infection... 

Basic laboratory tests complete blood count, blood chemistry screen, thyroid function, urinalysis, urine drug screen... 

Complete metabolic panel, complete blood cell count, and thyroid panel within normal limits... 

Temple S, Raff MC 1986 Clonal analysis of oligodendrocyte development in culture evidence for a developmental clock that counts cell divisions. Cell 44 773-779 Walters SN, Morell P 1981 Effects of altered thyroid states on myelinogenesis. J Neurochem 36 1792-1801... 

A complete physical examination and laboratory analysis are needed to rule out secondary causes and to assess kyphosis and back pain. Laboratory testing may include complete blood count, liver function tests, creatinine, urea nitrogen, calcium, phosphorus, alkaline phosphatase, albumin, thyroid-stimulating hormone, free testosterone, 25-hydroxyvitamin D, and 24-hour urine concentrations of calcium and phosphorus. Urine or serum biomarkers (e.g., cross-linked N-telopeptides of type 1 collagen, osteocalcin) are sometimes used. 

FIGURE 3-1. Bone health therapeutic algorithm for women. (BMD, bone mineral density CBC, complete blood count DXA, dual-energy x-ray absorptiometry PTH, parathyroid hormone RA, rheumatoid arthritis TSH, thyroid-stimulating hormone.)... 

Laboratory tests for identifying disorders that may cause or worsen HF include compete blood count serum electrolytes (including calcium and magnesium) renal, hepatic, and thyroid function tests urinalysis lipid... 

The diagnosis of menopause should include a comprehensive medical history and physical examination, complete blood count, and measurement of serum FSH. When ovarian function has ceased, serum FSH concentrations exceed 40 international units/L. Altered thyroid function and pregnancy must be excluded. 

In selected circumstances and secondary headache presentation, serum chemistries, urine toxicology profiles, thyroid function tests, lyme studies, and other blood tests, such as a complete blood count, antinuclear antibody titer, erythrocyte sedimentation rate, and antiphospholipid antibody titer may be considered. 

Rule out vitamin B]2 and folate deficiency Rule out hypothyroidism with thyroid function tests Blood cell counts, serum electrolytes, liver function tests Other diagnostic tests... 

Depressed patients should have a medication review, physical examination, mental status examination, a complete blood count with differential, thyroid function tests, and electrolyte determinations. 

Thyroid function tests BUN/creatinine EKG Liver enzymes Liver enzymes Reticulocyte count... 

The mainstay of therapy, a mood stabilizer, should be continued at the same dose that was used to achieve remission during acute phase therapy. Ongoing use of the mood stabilizer requires periodic monitoring of medication levels to ensure compliance. In addition to other laboratory evaluations such as complete blood counts, liver, kidney, and thyroid studies are needed to ensure that the mood stabilizer is being well tolerated. Lamotrigine is the only mood stabilizer that does not require periodic laboratory monitoring. 

Mandatory studies Complete blood count Blood electrolytes Liver enzymes Urinalysis Vitamin B,2 level Folate level Syphilis (RPR/VDRL) Thyroid-stimulating hormone (TSH) Brain scan (CT or MRI) Electrocardiograph (EKG)... 

In a subchronic inhalation study, rabbits exposed to 98 ppm 7 hours/day, 5 days/weekfor 6 months showed hemoglobin depression with some methemoglobin, elevated serum car-bamyl transferase, and thyroxin depression. For rats similarly exposed at 745 ppm, there was altered hematocrit, hemoglobin, and erythrocyte counts, altered prothrombin time, and increased thyroid weight. 

Parameters to monitor Perform the following laboratory tests prior to and periodically during lithium therapy Serum creatinine complete blood count urinalysis sodium and potassium fasting glucose electrocardiogram and thyroid function tests. Check lithium serum levels twice weekly until dosage is stabilized. Once steady state has been reached, monitor the level weekly. Once the patient is on maintenance therapy, the level may be checked every 2 to 3 months. 

Baseline tests CBC, hepatic function, pregnancy test, TSH, renal function, uric acid, HCVRNA level. Exclusions to treatment platelet count <90,000 cells/mm (as low as 75,000 cells/mm in patients with cirrhosis) absolute neutrophil count < 1,500 cells/mm serum creatinine concentration > 1.5 X upperlimit of normal abnormal thyroid function... 

BUN, blood urea nitrogen CBC, complete blood cell count CBZ, carbamazepine DVP, divalproex sodium EKG, electrocardiogram SIADH, syndrome of inappropriate secretion of antidiuretic hormone TSH, thyroid-stimulating hormone. 

Medical history and a physical examination should be completed for every patient. Given the physiological changes during ECT, the physical examination should include assessment of the airway, cardiovascular, pulmonary, and central nervous systems. Eaboratory examinations may include a blood count, liver and thyroid function tests, urine analysis, and electrocardiogram (EKG). Other investigations such as skeletal X-ray, completed tomographic (CT) scan of the... 

Note. SIADH=syndrome of inappropriate secretion of antidiuretic hormone CBC=complete blood count TSH=thyroid-stimulating hormone ECG=electrocardiogram AST=aspartate aminotransaminase ALT=alanine aminolransaminase. 

In this context, the first role of the laboratory is to detect specific adverse effects to target organs (see Role of the Laboratory later in this chapter). Monitoring will generally be tailored to the specific therapy used because of its known potential for causing certain problems. Examples include periodic blood counts with carbamazepine or clozapine and thyroid and renal function studies with long-term maintenance lithium. 

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