The Nonimpact of Thyroid Stunning: Remnant Ablation Rates in 131I-Scanned and Nonscanned Individuals

Thyroid stunning has been reported as the temporary impairment of thyroid tissue after a 111-MBq or greater diagnostic 131I dose that decreases the final absorbed dose in ablative therapy. Concerns regarding the reality of stunning have arisen in part due to a flawed study design in prior reports. To assess whether a stunning effect has any impact on therapeutic outcomes, we compared initial treatment ablation rates in patients who received 111- to 185-MBq 131I diagnostic scans (n = 37) before ablative doses of 3700–7400 MBq with ablation rates in patients who did not receive any 131I before the initial treatment dose (n = 63). Ablation rates were 64.9% for scanned patients and 66.7% for nonscanned patients, a nonsignificant difference. Nonscanned patients with metastatic lesions (n = 23) were ablated at a higher rate (78.3%) than scanned patients (n = 9) (66.7%), but the difference was not significant (P = 0.50). It is possible that the reported stunning phenomenon, specifically its impact in temporarily impairing tissue, has been overemphasized.

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Absorbed dose evaluation at different organs after 131I oral contamination of two Wistar rat models

BIO Web of Conferences ◽

10.1051/bioconf/20191407004 ◽

2019 ◽

Vol 14 ◽

pp. 07004

Author(s):

Meriem Mezaguer-Lekouaghet ◽

Eric Blanchardon ◽

Abdelwahab Badreddine ◽

Jean-Marc Bertho ◽

Maamar Souidi ◽

...

Keyword(s):

Rat Model ◽

Bladder Wall ◽

Thyroid Tissue ◽

Absorbed Dose ◽

Emission Spectra ◽

Wistar Rat ◽

Radiation Emission ◽

Rat Models ◽

Absorbed Doses ◽

The Difference

Iodine-131 (131I) is one of the most frequently used radionuclides for diagnosis and therapy of thyroid diseases. It is administered orally in the treatment of cancer to eliminate the residual postoperative microscopic tumor foci, and the residual normal thyroid tissue for early detection of recurrence [1]. The comparative behavior of 131I concentration into two animalmodels with total and partial thyroid has been investigated in our previous work [2]. The accumulated activities have been measured in fourteen organs. In this study, the mean absorbed doses resulting from 131I accumulated in all organs have been evaluated using RODES software [3, 4]. With this software, mean absorbed doses were calculatedfor selected organs (thyroid, lungs, heart, liver, kidneys, stomach, spleen, large and small intestine, testes, urinary bladder wall) by combining the specific absorbed fractions (SAF) of energy with radiation emission spectra and biokinetic data determined from our previous experimental study [2]. Calculations were based on the 131I photon and electron emissions reported by [5] and SAFs previously calculated by Monte Carlo simulation in the voxel phantom of an adult male rate [3, 4]. The obtained results show high absorbed dosesdeliveredto stomach and lungs for both models compared to other organs. The dose received by the testes and salivary glands is found to be higher in the case of the rat model without thyroid. Conversely, the spleen and bladder wall received lower doses in this latter model compared to those received by the rat model with thyroid. One can also note that the difference in mean absorbed dose received by liver, lungs, heart, and walls of the stomach is not significant between the two rat models.

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Telemedicine in pediatric and perinatal cardiology: Economic evaluation of a service in English hospitals

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462307051653 ◽

2007 ◽

Vol 23 (1) ◽

pp. 116-125 ◽

Cited By ~ 17

Author(s):

Robin Dowie ◽

Hema Mistry ◽

Tracey A. Young ◽

Gwyn C. Weatherburn ◽

Helena M. Gardiner ◽

...

Keyword(s):

Older Children ◽

Telemedicine Service ◽

Clinical Events ◽

District Hospitals ◽

Nonsignificant Difference ◽

Patient Groups ◽

Women And Children ◽

The Difference ◽

Set Up ◽

Mean Cost

Objectives:Pediatric cardiology has an expanding role in fetal and pediatric screening. The aims of this study were to observe how district hospitals use a pediatric telecardiology service, and to compare the costs and outcomes of patients referred to specialists by means of this service or conventionally.Methods:A telemedicine service was set up between a pediatric cardiac center in London and four district hospitals for referrals of second trimester women, newborn babies, and older children. Clinicians in each hospital decided on the role for their service. Clinical events were audited prospectively and costed, and patient surveys were conducted.Results:The hospitals differed in their selection of patient groups for the service. In all, 117 telemedicine patients were compared with 387 patients seen in London or in outreach clinics. Patients selected for telemedicine were generally healthier. For all patients, the mean cost for the initial consultation was £411 for tele-referrals and £277 for conventional referrals, a nonsignificant difference. Teleconsultations for women and children were significantly more expensive because of technology costs, whereas for babies, ambulance transfers were much more costly. After 6-months follow-up, the difference between referral methods for all patients was nonsignificant (telemedicine, £3,350; conventional referrals, £2,172), and nonsignificant within the patient groups.Conclusions:Telemedicine was perceived by cardiologists, district clinicians, and families as reliable and efficient. The equivocal 6-month cost results indicate that investment in the technology is warranted to enhance pediatric and perinatal cardiology services.

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A comparison of stimulus dosing methods for electroconvulsive therapy

Psychiatric Bulletin ◽

10.1192/pb.24.5.184 ◽

2000 ◽

Vol 24 (5) ◽

pp. 184-187 ◽

Cited By ~ 4

Author(s):

J. Laidlaw ◽

P. Bentham ◽

G. Khan ◽

V. Staples ◽

A. Dhariwal ◽

...

Keyword(s):

Electroconvulsive Therapy ◽

Initial Treatment ◽

Fixed Dose ◽

Dose Titration ◽

Titration Method ◽

Dose Prediction ◽

Dose Method ◽

Treatment Dose ◽

A Prospective Study ◽

Therapy Treatment

Aims and MethodsA prospective study comparing initial electroconvulsive therapy treatment doses determined by empirical dose titration with estimates derived from two simple dose prediction methods and a fixed-dose regimen (275 mC).ResultsThirty-three patients had seizure thresholds between 25 mC and 403 mC. The dose titration method led to a mean initial treatment dose of 195 mC that was intermediate between those predicted by the age method (275 mC) and the half-age method (137 mC). Estimates were within acceptable limits in 33% of cases for the age method, 64% for the half-age method and 40% for the fixed-dose method.Clinical ImplicationsEither dose prediction or dose titration methods may be more appropriate in different clinical situations. The half-age method appears to be a more accurate predictor of optimum initial treatment dose.

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Malignant Clinical Course of Histologically Benign Ovarian Struma: case report and literature review

10.21203/rs.3.rs-646069/v1 ◽

2021 ◽

Author(s):

Aleksandra Asaturova ◽

A. Magnaeva ◽

A. Tregubova ◽

V. Kometova ◽

E. Karamurzin ◽

...

Keyword(s):

Case Report ◽

Ovarian Tumor ◽

Clinical Course ◽

Mature Teratoma ◽

Thyroid Tissue ◽

Follicular Carcinoma ◽

Struma Ovarii ◽

Diagnostic Challenge ◽

Laboratory Findings ◽

Metastatic Lesions

Abstract BackgroundStruma ovarii is a variant of monodermal teratoma, consisting of morphologically benign, atypical, or frankly malignant thyroid tissue. Morphologic features may or may not correlate with biologic behavior. Albeit this case report is not unique, ovarian tumor developed with peritoneal dissemination and bone metastasis, which is highly unlikely clinical complication. Additionally, we summarized previously cases of struma ovarii with an emphasis on correlation between morphological appearances, clinical course and providing treatment. Case presentationWe present the 38-year-old patient who was hospitalized for ovarian tumor. The diagnostic laparoscopy revealed lesions of peritoneum, sigmoid serosa and omentum and left ovarian mass. We diagnosed left ovarian mature teratoma without struma tissue and metastatic lesions with struma morphology which can be related to her history of left ovarian struma in 2016. Taking into account the metastatic lesions revealed in 2020, the tumor removed in 2016 was assessed as highly differentiated follicular carcinoma arising in struma ovarii. ConclusionsPrediction of biologic behavior of struma ovarii is still to be to diagnostic challenge, therefore multidisciplinary approach including clinical a n d laboratory findings, radiologic details and histopathological features is required. Providing additional data, the present case report contributes to expending the knowledge of these peculiar neoplasms.

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Lowest effective 131I activity for thyroid remnant ablation of differentiated thyroid cancer patients

Nuklearmedizin ◽

10.3413/nukmed-0711-14-12 ◽

2015 ◽

Vol 54 (03) ◽

pp. 137-143 ◽

Cited By ~ 7

Author(s):

A.-S. Moldovan ◽

M. Ruhlmann ◽

R. Görges ◽

A. Bockisch ◽

S. Rosenbaum-Krumme ◽

...

Keyword(s):

Thyroid Cancer ◽

Cancer Patients ◽

Differentiated Thyroid Cancer ◽

Absorbed Dose ◽

Thyroid Remnant ◽

Remnant Ablation ◽

Dose Threshold ◽

131I Activity ◽

Pet Ct ◽

Absorbed Radiation Dose

SummaryAim: A theoretical dosimetry-based model was applied to estimate the lowest effective radioiodine activity for thyroid remnant ablation of low-risk differentiated thyroid cancer patients. Patients, methods: The model is based on the distribution of the absorbed (radiation) dose per administered radioiodine activity and the absorbed dose threshold of 300 Gy for thyroid remnants, the level believed to destroy most thyroid remnants. For this purpose, 124I PET/CT images of 49 thyroid-ectomised patients were retrospectively analysed to measure the distribution of the (average) absorbed doses to thyroid remnant per administered 131I activity. The fraction of thyroid remnants that received at least 300 Gy was determined for standard activities between 0.37 and 5.55 GBq. The lower activity was considered to be equally effective to that obtained with higher activity if the (absolute) fraction difference was below 5%. Results: A total of 62 thyroid remnants were included. The medians and ranges (in parentheses) for the absorbed dose per unit 131I activity were 359 Gy/GBq (34 to 1825 Gy/ GBq). The fractions of thyroid remnants receiving more than 300 Gy at different therapy activities (within parentheses) were 60% (1.11 GBq), 76% (1.85 GBq), 79% (2.22 GBq), and 81–82% for activities between 2.59 and 3.70 GBq. The therapy activity of 1.11 GBq is considerably less effective than that of 1.85 or 2.22 GBq; therapy activities were equally effective in the range between 2.22 to 3.70 GBq. Conclusion: On the basis of the model and the patients' data included, the lowest effective therapy activity appears to be approximately 2.2 GBq to ablate thyroid remnants. The results of this study may help to guide the design of prospective clinical studies.

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Evaluation of Therapeutic Efficacy and Safety of Tranexamic Acid Local Infiltration in Combination with Topical 4% Hydroquinone Cream Compared to Topical 4% Hydroquinone Cream Alone in Patients with Melasma: A Split-Face Study

Dermatology Research and Practice ◽

10.1155/2018/8350317 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Zohreh Tehranchinia ◽

Bita Saghi ◽

Hoda Rahimi

Keyword(s):

Tranexamic Acid ◽

Efficacy And Safety ◽

Local Infiltration ◽

Patient’S Satisfaction ◽

Treatment Groups ◽

Exposed Skin ◽

Therapeutic Outcomes ◽

Satisfaction With Treatment ◽

The Difference ◽

Split Face

Introduction. Melasma is an acquired pigmentary disorder characterized by hyperpigmented macules and/or patches affecting sun-exposed skin. Tranexamic acid (TA) can reduce melanin content of epidermis. Thus, we conducted this study to evaluate the efficacy and safety of tranexamic acid local infiltration in combination with topical 4% hydroquinone cream compared to topical 4% hydroquinone cream alone in patients with melasma.Material and Methods. This study was a prospective assessor- and analyst-blind, randomized split-face clinical trial which was performed on patients with bilateral malar epidermal melasma. A total of 55 patients were enrolled, and each side of their face was randomly allocated to either TA+HQ or HQ alone treatment. The MASI score was applied as an objective measurement to compare two treatment groups. The patient's satisfaction of melasma treatment was evaluated using a four-scale grading, as well.Results. The mean of MASI score in week 16 decreased in both groups significantly (p < 0.01). The therapeutic outcomes were significantly better in TA+HQ group than HQ group (p=0.001). Patients satisfaction with treatment was significantly higher in the TA + HQ group. The difference between the two groups regarding side effect occurrence was not statistically significant.Conclusion. Addition of tranexamic acid injections to conventional hydroquinone therapy can increase the efficacy of topical treatment.This trial is registered withIRCT2015110324865N1.

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Gender Differences of B Cell Signature in Healthy Subjects Underlie Disparities in Incidence and Course of SLE Related to Estrogen

Journal of Immunology Research ◽

10.1155/2014/814598 ◽

2014 ◽

Vol 2014 ◽

pp. 1-17 ◽

Cited By ~ 23

Author(s):

Hongye Fan ◽

Guanjun Dong ◽

Guangfeng Zhao ◽

Fei Liu ◽

Genghong Yao ◽

...

Keyword(s):

Gender Differences ◽

B Cells ◽

Global Gene Expression ◽

Gene Expressions ◽

Significant Difference ◽

Healthy Female ◽

Nonsignificant Difference ◽

Differential Gene ◽

The Difference ◽

Healthy Females

The aim of the present study was to investigate mechanism of the gender differences of B cells. The results showed that 358 differential gene expressions (DEGs) were displayed between healthy females and males. Compared with male, 226 and 132 genes were found to be up- and downregulated in the female. 116 genes displayed possible correlation with estrogen. Moreover, the upregulated DEGs (Cav1, CD200R1, TNFRSF17, and CXCR3) and downregulated DEGs (EIF1AY and DDX3Y) in healthy female may be involved in gender predominance of some immune diseases. Furthermore, signaling pathway analysis for estrogen-relevant DEGs showed that only 26 genes were downregulated in SLE female versus SLE male, of which expressions of 8 genes had significant difference between SLE females and SLE males but are having nonsignificant difference between healthy females and healthy males. Except for the 5 Y-chromosome-related genes or varients, only 3 DEGs (LTF, CAMP, and DEFA4) were selected and qRT-PCR confirmed that the expressions of LTF and CAMP decreased significantly in B cells from female SLE patients. These data indicated that the gender differences were existent in global gene expression of B cells and the difference may be related to estrogen.

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Dosimetry and Therapeutic Ratios for Rhenium-186 HEDP

ISRN Molecular Imaging ◽

10.1155/2013/124603 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Maria Argyrou ◽

Alexia Valassi ◽

Maria Andreou ◽

Maria Lyra

Keyword(s):

Absorbed Dose ◽

Short Review ◽

Metastatic Lesion ◽

Patient Specific ◽

Skeletal Metastases ◽

Dose Estimation ◽

Metastatic Lesions ◽

Short Period ◽

Accurate Dose ◽

High Doses

Rhenium-186 (Re-186) is a β-emitting radionuclide. Emitted β-particles have ranges up to 4.5 mm in tissue, capable of delivering high doses to skeletal regions of high Re-186 concentrations while sparing adjacent radiosensitive regions and thus making the irradiation well tolerated for the patient. Along with the β-emissions, γ-rays are emitted having an adequate energy for imaging during therapy and biodistribution assessment for patient-specific dosimetry calculations. The relatively short physical half-life combined with the β-emissions allows the delivery of relatively high activity rate for a short period of time in areas of concentration. This study is a short review concerning the palliative treatment of skeletal metastases using 186Re-HEDP. After presenting the dominant ways of 186Re production, special emphasis is given to dosimetry issues while the effect of palliation therapy can be evaluated through the comparison of the absorbed dose in metastatic lesion relatively to the normal bone region. Accurate dose estimation is required taking into account the anatomic individual difference of each patient. For this purpose a patient specific dosimetric model considering metastatic lesions as spherical nodules is introduced. In order to quantify in a representative way the results of palliation treatment, the concept of therapeutic ratios is analyzed.

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UGT1As polymorphisms predict toxicity in colorectal cancer patients treated with different recommended doses of irinotecan oriented by UGT1A1*28 polymorphism based on previous phase I study

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.14511 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 14511-14511 ◽

Cited By ~ 1

Author(s):

S. Hazama ◽

H. Koudo ◽

S. Yoshida ◽

R. Shimizu ◽

H. Ozasa ◽

...

Keyword(s):

Colorectal Cancer ◽

Maximum Tolerated Dose ◽

Wild Type ◽

Eligibility Criteria ◽

Metastatic Lesions ◽

Significant Difference ◽

The Difference ◽

Colorectal Cancer Patients ◽

Previous Phase ◽

Written Informed Consent

14511 Background: We have presented at 2006 ASCO annual meeting about a genetic UGT1A1 polymorphism oriented phase (P) I study of Irinotecan and 5’-DFUR for metastatic colorectal cancer (MCRC) to determine the maximum tolerated dose (MTD) and the recommend doses (RD) for each UGT1A1 *1/*1 and *1/*28 genotypes. The RD of biweekly Irinotecan administration was 150 mg/m2 for patients (pts) with wild *1/*1 genotype and 70 mg/m2 of Irinotecan for mutated *1/*28. Now we are carrying out a *28 oriented P II study based on this RD. Here we report the profiles of toxicities in the P II study of irinotecan and 5’-DFUR to analyze other kinds of UGT1As polymorphisms in relation to irinotecan toxicities. Patients & Methods: Eligibility criteria were as follows; histologically proven CRC with unresectable metastatic lesions, PS 0–1, age<76, adequate organ functions, and written informed consent. Twenty one pts with wild type genotype and 9 pts with mutated genotype were enrolled. Irinotecan was infused 150 mg/m2 for pts with *1/*1 genotype and 70 mg/m2 for *1/*28. Hematological and non-hematological toxicities were graded, and UGT1As polymorphisms (UGT1A1*6 and *7, UGT1A7*1*2*3*4, UGT1A9*22) were analyzed. Results: Grade (G)3 & 4 toxicities were observed in 6 of 22 (27%) wild type pts and in 3 of 9 (33%) mutated pts, and in 9 of 31 (29%) all pts. There was no significant difference on the profiles of toxicities between the pts with wild genotype and mutated genotype, irrespective of the difference of the quantity of irinotecan. So, the RD was thought to be adequate. In pts with UGT1A1*6 allele, G3 & 4 toxicities were observed 6/11 (55%), on the other hand 3/20 (15%) in pts without *6 allele (p=0.038). G3 & 4 toxicities were also more frequent in pts with UGT1A7*3 alleles than pts without *3 allele (p<0.10). Conclusions: The profiles of toxicities of pts with *1/*1 or *1/*28 genotypes were similar irrespective of the difference of the quantity of irinotecan. The result indicated that the RD of latest PI for each group was adequate, and this P II study is suitable to analyze other kinds of polymorphisms that have correlation to irinotecan toxicities. UGT1A1*6 and UGT1A7*3 allele will be a novel predictor for toxicity of irinotecan. No significant financial relationships to disclose.

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