scholarly journals Clinician’s awareness and knowledge on the management of differentiated thyroid cancer and the use of radioactive iodine in Tanzania

2016 ◽  
Vol 18 (2) ◽  
Author(s):  
Lulu L. Sakafu ◽  
Teddy Mselle ◽  
Julius Mwaiselage ◽  
Amina Msengwa ◽  
Khamza Maunda ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Thyroxine Therapy ◽  
Post Surgery ◽  
Referral Hospitals ◽  
Poor Treatment Outcome

Introduction: Thyroid cancer is the most common endocrine malignancy worldwide with better outcome if timely and properly managed. Surgery followed by radioactive iodine (RAI) ablation remains the mainstay in the management of differentiated thyroid cancer (DTC). In Tanzania however, few patients with DTC receive RAI ablation post-surgery, and most of these present late, with advanced disease resulting in poor treatment outcome. The objective of this study was to determine the course for late referral by assessing clinician’s awareness and knowledge on the management of DTC and the use of RAI in Tanzania.Methods: This descriptive cross sectional study was carried out in referral hospitals in Tanzania. Data collection used a standardized self-administered questionnaire. Information sought included awareness, knowledge and practices of clinicians on the management and the use of RAI on patients with DTC was explored.Results: Majority of clinicians managing DTC patients were males (86%), in-training surgeons (54%), and attended less than ten DTC patients per year (62%). About 44% of in-training surgeons never heard of nuclear medicine (p=0.04), and 20% were not aware of the role of RAI in the management of DTC (p=0.031). Only 7.3% of surgeons were aware of the role of thyroxine therapy, or RAI ablation post-surgery. Of all DTC patients managed surgically, only 16% had total thyroidectomy with lymphadenectomy (p=0.05).Conclusion: The findings of this study indicate there is insufficient knowledge on proper management and use of RAI on patients with DTC among clinicians in Tanzania.

scholarly journals Magnitude of maternal near misses and the role of delays in Ethiopia: a hospital based cross-sectional study

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Mulugeta Dile Worke ◽  
Habtamu Demelash Enyew ◽  
Maru Mekie Dagnew
Keyword(s):  
Antenatal Care ◽  
Health Care Access ◽  
Cross Sectional Study ◽  
Near Miss ◽  
Sectional Study ◽  
Cross Sectional ◽  
Near Misses ◽  
Care Access ◽  
Referral Hospitals

Abstract Objectives This study was aimed to assess the magnitude of maternal near misses and the role of delays including other risk factors. A Hospital based cross sectional study was conducted at three referral hospitals of Amhara region on 572 mothers who came to obtain obstetrics care services from February 01 to July 30, 2018. Results The magnitude of maternal near miss was 26.6% (95% CI 23, 30). With regards to delays, 83 (14.5%), 226 (39.5%), and 154 (26.9%) of women delayed in the decision to seek care, in reaching care, and in receiving care respectively. Women who had no antenatal care [AOR = 3.16; CI (1.96, 5.10)], who stayed in hospital 7 days or more [AOR = 2.20; CI (1.33, 3.63)] and those who had delay in reaching health facility [AOR = 1.99; CI (1.10, 3.61)] were more likely to be near miss. While, women whose husband was able to read and write [AOR = 0.29; CI (0.09, 0.96)] and those with monthly household income between 2001 and 3000 ETB [AOR = 0.35; CI (0.18, 0.70)] were 71% and 65% less likely to be near misses respectively. Promoting antenatal care and increasing maternal health care access could have significant impact in reducing maternal near misses.

Differentiated Thyroid Cancer lymph-node relapse. Role of adjuvant radioactive iodine therapy after lymphadenectomy

2016 ◽  
Vol 44 (6) ◽  
pp. 926-934 ◽  
Author(s):  
Arnoldo Piccardo ◽  
Matteo Puntoni ◽  
Gianluca Bottoni ◽  
Giorgio Treglia ◽  
Luca Foppiani ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Radioactive Iodine Therapy

scholarly journals Causes of False-Positive Radioactive Iodine Uptake in Patients with Differentiated Thyroid Cancer

2021 ◽  
Vol 9 (6) ◽  
Author(s):  
Karin Wu ◽  
Uzoezi Ozomaro ◽  
Robert Flavell ◽  
Miguel Pampaloni ◽  
Chienying Liu
Keyword(s):  
Thyroid Cancer ◽  
False Positive ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Imaging Modality ◽  
Whole Body ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Patient’S History ◽  
Radioactive Iodine Uptake

Abstract Purpose Radioactive iodine (RAI) whole-body scan is a sensitive imaging modality routinely used in patients with differentiated thyroid cancer to detect persistent and recurrent disease. However, there can be false-positive RAI uptake that can lead to misdiagnosis and misclassification of a patient’s cancer stage. Recognizing the causes of false positivity can avoid unnecessary testing and treatment as well as emotional stress. In this review, we discuss causes and summarize various mechanisms for false-positive uptake. Recent Findings We report a patient with differentiated thyroid cancer who was found to have Mycobacterium avium complex infection as the cause of false-positive RAI uptake in the lungs. Using this case example, we discuss and summarize findings from the literature on etiologies of false-positive RAI uptake. We also supplement additional original images illustrating other examples of false RAI uptake. Summary False-positive RAI uptake may arise from different causes and RAI scans need to be interpreted in the context of the patient’s history and corresponding cross-sectional imaging findings on workup. Understanding the potential pitfalls of the RAI scan and the mechanisms underlying false uptake are vital in the care of patients with differentiated thyroid cancer.

Uncertainty in the management of thyroid cancer.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 238-238
Author(s):  
Megan Haymart ◽  
Mousumi Banerjee ◽  
Di Yang ◽  
Andrew Stewart ◽  
James Sisson ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Radioactive Iodine ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
Cancer Management ◽  
Post Surgery ◽  
Iodine Treatment

238 Background: Little is known about treatment practices in thyroid cancer, a cancer that is increasing in incidence. We sought to identify aspects of thyroid cancer management that have the greatest variation and thereby uncertainty in management. Methods: We surveyed 944 physicians involved in thyroid cancer care from 251 hospitals affiliated with the U.S. National Cancer Database. Using vignettes and additional survey items, physicians were asked questions in the following four domains: thyroid surgery, radioactive iodine use, thyroid hormone replacement post-surgery, and long-term thyroid cancer management. To identify aspects of thyroid cancer management with the greatest uncertainty, we calculated the ratio of observed variation to hypothetical maximum variation under the assumed distribution of the response. Ratios closer to 1 indicate greater uncertainty. Results: There is large uncertainty in multiple aspects of thyroid cancer management, including the role of central lymph node dissections, the role of pretreatment scans before radioactive iodine treatment, and all aspects of long-term thyroid cancer management, including applications of ultrasound and radioactive iodine scans. For the management of small thyroid cancers, uncertainty exist in all domains, including optimal extent of surgery and the role of both radioactive iodine treatment and suppressive doses of thyroid hormone replacement. Conclusions: We identified areas of uncertainty in thyroid cancer management. Since both a lack of data and a lack of acceptance of the existing data may be contributing to the variation demonstrated, to improve the management of thyroid cancer there is a need for more research and more research dissemination.

scholarly journals The Association between Dietary Intakes and Differentiated Thyroid Cancer: A Cross-Sectional Study among Patients and Healthy People in Iran

2020 ◽  
Author(s):  
Zohreh Sadat Sangsefidi ◽  
Abdolreza Norouzy ◽  
Mohammad Safarian ◽  
Roxana Kashanifar ◽  
Raheleh Pourbaferani ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Protective Effect ◽  
Differentiated Thyroid Cancer ◽  
Dietary Assessment ◽  
Cross Sectional Study ◽  
Protective Role ◽  
Dietary Intakes ◽  
Low Fat ◽  
Cross Sectional ◽  
The Relationship

Background: Differentiated thyroid cancer (DTC) is the most prevalent endocrine cancer. Evidence showed a significant association between diet and DTC. Thus, this study aimed to assess the relationship between dietary intakes and DTC. Methods: This case-control study was accomplished among 300 adult patients and 300 matched (age and gender) controls in Mashhad city, Iran. Dietary assessment was conducted and the relationship between dietary intakes and DTC were examined by a validated food-frequency questionnaire and logistic regression analysis, respectively. Results: After adjusting for the confounders, a protective effect was observed for the highest tertile of low-fat dairy (OR=0.3, 95% CI=0.17-0.53, P < 0.001) and fruits' intakes (OR=0.28, 95% CI=0.15-0.52, P < 0.001) on DTC. However, the highest tertile of sugar intake was significantly related to greater DTC chance (OR=4.01, 95% CI=2.07-7.79, P < 0.001). A protective role was also found for vegetables in the second tertile of consumption (OR=0.3, 95% CI= 0. 0.17-0.54, P < 0.001) and for tea in the second and third tertiles (OR=0.2, 95% CI= 0.11-0.53, P < 0.001; OR=0.42, 95% CI=0.26-0.69, P = 0.001 respectively). However, the second and third tertiles of the roasted or fried meat consumption were significantly associated with higher DTC chance (OR=1.66, 95% CI= 1.007-2.76, P = 0.04; OR=1.92, 95% CI=1.07-3.42, P = 0.02 respectively). No significant association was detected for other dietary intakes. Conclusions: Consumption of low fat dairy, fruits, vegetables, and tea had a protective effect on DTC; whereas, roasted or fried meat and sugar consumption was significantly associated with higher DTC chance. Further studies are needed to confirm these results.

APOPTOSIS ROLE IN FORMING RADIOIODINE RESISTANCE IN DIFFERENTIATED THYROID CANCER

2020 ◽  
pp. 301-310
Author(s):  
K.A. GARIPOV ◽  
◽  
Z.A. AFANASIEVA ◽  
A.D. GAFIULLINA ◽  
◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Molecular Mechanisms ◽  
Radioactive Iodine ◽  
Tumour Regression ◽  
Therapeutic Effects ◽  
Multikinase Inhibitors ◽  
Complete Tumour ◽  
Apoptosis Proteins

According to studies, 25-66% of patients with metastatic highly differentiated thyroid cancer (DTC) develop partial or complete resistance of metastases to therapy with radioactive iodine. The review discusses the molecular mechanisms for the involvement of various apoptosis proteins in the formation of radioiodine resistance in patients with DTC, as well as the molecular mechanisms of the action of multikinase inhibitors, with a range of therapeutic effects from complete tumour regression to stabilization, on apoptosis. Considering the literature on the ambiguous role of apoptosis in the formation of radioiodine resistance in DTC, required further examination of its molecular mechanisms, its relationship with such a process as autophagy, the effect of multikinase inhibitors on its molecular basis and on overcoming iodine resistance. Studying the mechanism of apoptosis regulations gives a chance to find new targeted aims exposure in its individual stages in order to regulate or correct them.

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