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Objective: The study aimed to assess the impact of postoperative radioactive iodine (RAI) therapy on parathyroid function in patients who underwent total or subtotal thyroidectomy for differentiated thyroid cancer (DTC). Methods: Data from 150 patients treated with RAI for DTC and 76 patients with low-risk DTC not receiving RAI were retrospectively analyzed. Clinical characteristics, preoperative and 1-month postoperative biochemical parameters, and adjusted calcium, phosphorus, parathyroid hormone (PTH), and 25-hydroxyvitamin D3 (25-OH-D) levels at 3 months, 1 year, 3 years, and 5 years post-RAI (or in the low-risk group) were recorded. Results: A total of 226 DTC patients were included in the study (80.5% female, mean age 42.7 ± 13.2 years). Total thyroidectomy was performed in 97.3% (n = 220) of patients, with central lymph node dissection (CLND) in 41.6% (n = 94). No significant preoperative differences in PTH, aCa, P, Mg, or 25-hydroxyvitamin D3 levels were observed. However, patients receiving ≥ 3.7 GBq (or 100 mCi) RAI (n = 70) had lower calcium and PTH levels at the end of the first year following RAI treatment (p = 0.048, p = 0.032). The non-RAI group showed significantly higher calcium levels at one month postoperatively (p = 0.031) and lower rates of CLND and neck dissection. No significant differences in biochemical parameters were found at the five-year follow-up, except for one patient who developed normocalcemic hyperparathyroidism after RAI. Conclusion: High-dose RAI therapy may lead to transient decreases in calcium and PTH levels in the early post-treatment period. However, long-term parathyroid function appears to remain unaffected in DTC patients, regardless of the RAI dose administered. Nonetheless, close monitoring of calcium and PTH levels is recommended, particularly in the early post-treatment period, to promptly manage any potential transient hypoparathyroidism. [ABSTRACT FROM AUTHOR]

Background: The association of radioactive iodine (RAI) with disease-specific survival (DSS) is controversial in N1b papillary thyroid carcinoma (PTC). We aimed to evaluate whether RAI is associated with DSS in low-to-intermediate-risk N1b PTC. Methods: The Surveillance, Epidemiology, and End Results database was queried for pT1-3, N1b, M0/Mx classic PTC treated with total thyroidectomy. Multivariable Cox regression was performed to identify predictors of DSS. Subanalyses were conducted for age, intermediate-risk versus otherwise low-risk features, and positive lymph node ratio (LNR) > 0.17. Results: Radioactive iodine recipients were younger (43.0 vs. 44.0 years, p = 0.036) with increased capsular or local invasion (49.2% vs. 41.9%, p < 0.001) and median LNR (0.37 vs. 0.33, p = 0.001). Worse DSS was associated with age (adjusted-HR = 1.09, p < 0.001), tumor size (adjusted-HR = 1.02, p < 0.001), and local invasion (adjusted-HR = 1.86, p = 0.003). Radioactive iodine was associated with improved DSS in the whole cohort (adjusted-HR = 0.61, p = 0.014), in patients ≥ 55 years (adjusted-HR = 0.48, p = 0.001) and in patients ≥55 years with LNR > 0.17 (adjusted-HR = 0.45, p = 0.001) but not LNR ≤ 0.17. Radioactive iodine was not associated with a DSS benefit in patients < 55 years even when stratified by LNR 0.17. Radioactive iodine administered to patients with at least one intermediate-risk feature (> 5 pathologic LNs or any local invasion) was associated with improved DSS (adjusted-HR = 0.60, p = 0.019) but not those with otherwise low-risk features (adjusted-HR = 0.71, p = 0.502). Conclusions: Radioactive iodine is associated with improved DSS in N1b PTC patients with intermediate-risk features, age ≥ 55 years, and LNR > 0.17 in older patients, but not in patients with otherwise low-risk features. These factors could help guide RAI utilization in N1b PTC. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the efficacy of postoperative radioactive iodine (RAI) and its impact on recurrence rates and survival benefits in low- to intermediate-risk papillary thyroid carcinoma (PTC). Methods: This retrospective study involved the examination of 1286 patients diagnosed with low- to intermediate-risk PTC who underwent total thyroidectomy with or without neck dissection, supplemented with postoperative RAI therapy or not between the years 2000 and 2021. Results: From the patient pool, 589 (45%) were classified as low-risk and 697 (55%) as intermediate-risk according to the 2015 American Thyroid Association guidelines. Among the low-risk group, 375 (63.7%) underwent postoperative RAI, while in the intermediate-risk group, 566 (82.2%) underwent the procedure. The overall survival and disease-free survival rates were not statistically different between the groups that received RAI and those that did not, in both the low- and intermediate-risk categories. In a subgroup analysis, within the intermediate-risk category, postoperative RAI was significantly correlated with decreased recurrence in two subgroups: patients over 55 years with pN1b disease (hazard ratio 0.043, 95% confidence interval 0.004–0.500, p = 0.012) and patients over 55 years with five or more metastatic lymph nodes (hazard ratio 0.060, 95% confidence interval 0.005–0.675, p = 0.023). Conclusion: Our findings suggest that, while post-total thyroidectomy RAI does not substantially influence recurrence or survival rates in most low-risk and intermediate-risk PTC patients, it may be beneficial in specific subgroups, particularly patients over 55 with pN1b disease or those presenting with five or more metastatic lymph nodes. [ABSTRACT FROM AUTHOR]

Background: Surgery stands as the cornerstone treatment for differentiated thyroid cancer (DTC). After surgery, radioactive iodine (RAI) administration is primarily recommended for high-risk patients and commonly employed to address residual disease or mitigate the risk of recurrence. However, the optimal application of RAI in cases categorized as low to intermediate risk is still uncertain. This study aims to assess the indication of post-surgical RAI treatment specifically in patients diagnosed with DTC falling within the low to intermediate risk category for recurrent disease. Methods: retrospective analysis of consecutive patients with DTC falling within the low to intermediate risk category for recurrence and diagnosed between 2009–2015. Patients were categorized into either treated or untreated with RAI. Treatment effect was assessed by the inverse-probability weighted regression adjustment (IPWRA), by balancing the distribution of factors influencing outcome and treatment assignment. Results: after surgery, 328 patients (69.9%) were treated with RAI while 141 (30.1%) were left untreated. Across the entire cohort, 44 individuals (9.4%) displayed biochemical or structural disease after a median time of 17.5 months following diagnosis. Recurrent disease was more prevalent in patients who underwent RAI treatment compared to those untreated (12.5% vs 2.1%, respectively, p < 0.001). Factors independently associated with recurrent disease, identified through multivariate logistic regression analysis, included lymph node metastases (pN1) (OR = 4.07; 95% CI 1.84–8.97), male sex (OR = 2.71; 95% CI 1.31–5.59), tumor size (OR = 1.03; 95% CI 1.00–1.06), and microscopic extrathyroidal extension (OR = 2.36; 95% CI 1.15–4.81). IPWRA analysis revealed that the occurrence of recurrent disease was 9.6% (95% CI = 6.3–12.9) in RAI-treated patients and 15.9% (95% CI = 11.1–20.71) in untreated patients (p = 0.021). As a consequence, if all patients underwent RAI treatment, the estimated risk of recurrence would be reduced by 42% (RR = 0.58; 95% CI = 0.35–0.91, p = 0.018). The greatest benefit was observed in patients with 2 intermediate risk factors. Conclusions: These results suggest that treatment with RAI in low to intermediate DTC can reduce the risk of recurrence in selected patients. However, definitive answers regarding whether to consider RAI therapy for this category of patients can only be attained through prospective clinical trials. Up to date these results recommend a meticulous assessment of tumor characteristics at diagnosis to guide the decision regarding RAI administration. [ABSTRACT FROM AUTHOR]

Purpose: Although most patients with differentiated thyroid carcinoma (DTC) have an excellent prognosis, a subset will experience radioactive iodine refractory (RAI-R) disease, associated with recurrence, distant metastases and worse prognosis. In recent years, redifferentiation has emerged as an attractive approach for patients with RAI-R DTC, a strategy to induce iodine uptake in RAI-R DTC tumor cells and ultimately prolong time to initiation of systemic therapy. Methods: An overview and critical appraisal of the existing literature on redifferentiation will be presented in this review under the lens of the genotype-specific targeted therapy administered with redifferentiation intent. Results/conclusions: Due to the significant heterogeneity across studies, it will be key to harmonize research methodology and support future larger, multicenter prospective trials in order to identify the most suitable candidates for this therapeutic strategy. [ABSTRACT FROM AUTHOR]

Background: Continuously monitored external dose-rate signals from remote dose-rate meters (DRMs) were analyzed to determine the effective half-life (Teff) of 131I in differentiated thyroid cancer (DTC) patients. The aim is to gain novel understanding of the excretion of radioactive iodine (RAI) in DTC patients and to demonstrate that a remote DRM system can be reliably used for real-time monitoring of external dose-rates of DTC patients. Methods: 110 DTC patients who received postoperative RAI therapy between September 2018 and February 2023 in Turku University Hospital were studied retrospectively. The external dose-rates of the patients were continuously monitored during their hospitalization with a remote DRM fixed in the ceiling of the isolation room. Generalized linear mixed model (GLMM) was used to analyse the association between logarithmical Teff and patient characteristics. Results: The median Teff for all patients was 12.60 h (Q1: 10.35; Q3: 14.75 h). Longer Teffs were associated with higher BMI (p = 0.004), lower GFR (p < 0.001), and diabetes (p = 0.007). Our study also revealed that neither age nor subsequent RAI therapies have a significant impact on the whole body Teff (p = 0.522 and p = 0.414, respectively). Conclusion: Patients with higher BMI, decreased GFR, or diabetes have a longer whole-body Teff of 131I. Ceiling-mounted remote DMRs can reliably be used to determine patient's Teff. Since Teff values vary among patients, ceiling-mounted meters can be used to optimize the length of radiation isolation period at the hospital while improving patient comfort and staff efficiency. [ABSTRACT FROM AUTHOR]

This study explored the role of radioiodine therapy (RAI) in low-risk thyroid cancer patients and examined the disease-specific survival (DSS) rates in a large cohort of differentiated thyroid cancer patients (DTC). We obtained patient data from SEER database. Patients who underwent total thyroidectomy were included and categorized into three groups based on histology: classical papillary thyroid carcinoma (C-PTC), follicular type variant carcinoma (FV-PTC), and follicular thyroid cancer (FTC). Patients with distant metastasis, tumor size ≥ 200 mm, chemotherapy, or any type of radiation other than RAI were also excluded. A nomogram was developed and tested for discrimination and calibration. In total, 96,532 thyroid cancer cases were examined, including 59,460 C-PTC, 31,583 FV-PTC, and 5,489 FTC cases. Age > 65 years and male sex were correlated with lower survival rates across the subtypes. In addition, extrathyroidal extension had a worse survival effect in patients with FTC. DSS rates were compared between patients who received RAI and those who did not, with a 3% difference in C-PTC (94% vs. 91%, p < 0.001), 2% in FV-PTC (92% vs. 90%, p < 0.001), and 1% in FTC (89% vs. 88%, p = 0.084) at 15 years. The nomograms for long-term DSS showed high discriminatory abilities with C-indices of 0.815, 0.805, and 0.781 for C-PTC, FV-PTC, and FTC, respectively. The developed nomogram can be used in the treatment plan for patients with DTC. Our study emphasizes the prognostic factors for DTC and highlights the need for personalized treatment plans based on individual risk profiles. [ABSTRACT FROM AUTHOR]

To ensure the maximal possible production intensity for iodine-based radiopharmaceuticals, various methods for target cooling (e.g., front-side cooling of ТеО2 target using air, helium, and fine-dispersed water flow) have been investigated. Using the COMSOL Multiphysics simulation software package, the temperature field of the target cooled by different heat carriers have been compared for the production output of iodine. [ABSTRACT FROM AUTHOR]

Objective: Thyroid cancers are on the rise, but the associated vital prognosis and long-term survival rates are very good. Therefore, treated patients' quality of life and psychological well-being are important considerations. The treatment usually involves surgery and radioactive iodine (radioiodine) ablation. This study aims to investigate potential effects of radioiodine ablation therapy on health-related quality of life, anxiety and depression symptoms, and nutritional status at 6 months post-therapy. Methods: This study included 136 patients diagnosed with thyroid cancer. Absorbed doses to the salivary glands were estimated from dosimeters worn by patients. Patient health-related quality of life, psychological status and nutritional status were assessed before and 6 months after therapy using standardized questionnaires (including SF-36, Hospital Anxiety and Depression (HAD) scale). Statistical analyses included random-effects logistic and linear regressions adjusted for potential confounders. Results: While no significant association was found between radioiodine exposure and anxiety or depression symptoms, or nutritional status, a significant increase in the SF-36 role physical sub- score was observed in relation with the salivary gland dose (β= 6.54, 95%CI 2.71;10.36 for a 1-Gy increase). Conclusions: The findings suggest an improved physical health-related quality of life, namely reduced pain and functional impairment, 6 months after radioiodine therapy in thyroid cancer patients. No significant association was found between radioiodine exposure and mental health-related quality of life, anxiety or depression scores nor nutritional status. This study does not provide any evidence that radioiodine therapy has a potentially adverse effect on patient health-related quality of life. [ABSTRACT FROM AUTHOR]

Graves' disease (GD) is a systemic autoimmune disorder mainly affecting the thyroid gland. During GD management, the principal target is to control the hyperthyroid state. There have been three rather similarly effective modalities: medical therapy with antithyroid drugs (ATD), radioactive iodine (RAI), or surgical excision of the thyroid tissue (thyroidectomy). Defining the relative risks and benefits of each of the two potential definitive treatment options (RAI or thyroidectomy) is crucial for creating evidence-based therapy algorithms. This systematic review and meta-analysis aimed to compare the outcomes of these two treatment options. This is a systematic review and meta-analysis that analyzed the studies comparing RAI and thyroidectomy to treat GD. Studies were obtained by searching on Scopus, the Cochrane Central Register of Controlled Trials, and PubMed central database. The surgically treated group showed significantly lower failure rates, non-significantly lower cardiovascular morbidities, non-significantly higher complication rates, and significantly lower mortality rates. The RAI-related complications were mostly the development or worsening of Graves' ophthalmopathy. This review and meta-analysis comparing surgery and radioactive iodine for the treatment of Grave's disease from 16 well-conducted trials has shown that although surgery viz., total thyroidectomy was less frequently utilized for the treatment of Grave's disease, it controlled the symptoms with greater success and without any worsening of Grave's ophthalmopathy. [ABSTRACT FROM AUTHOR]

Background: The incidence of thyroid cancer has been increasing among the population less than 20 years of age, especially during the second decade of life. Differentiated papillary thyroid cancer is the most common pathology in children. It usually presents with thyroid nodules with or without cervical lymphadenopathy. Thyroid nodules carry a considerable risk of malignancy in children. Case presentation: We herein report a 5-year-old girl with poorly differentiated papillary thyroid cancer which is an extremely rare finding at this age. The patient underwent right thyroid lobectomy followed by left hemi thyroidectomy and right central and lateral neck dissection. Pathologic examination revealed a poorly differentiated papillary thyroid carcinoma with nodal deposits. Conclusion: It is essential to raise awareness of proper evaluation and management of thyroid nodules at such an age. [ABSTRACT FROM AUTHOR]

Sorbents for anionic species of iodine are required at every stage of 129I management. Development of iodine adsorbing material suitable for usage as engineered safety barriers (ESB) component in deep geological repository (DGR) sites or geological disposal facilities (GDF) is a particularly important concern due to the final of disposal iodine-containing radioactive waste is one of the most challenging problem in nuclear industry nowadays. This literature review discusses data on silver-containing materials, which are characterized with the highest sorption properties towards anionic iodine species and high fixation permanence of radioiodine. Emphasis is on materials with high surface area modified with silver in various chemical forms (Ag+, Ag0, Ag2O, AgCl etc.), methods of these materials obtaining are analyzed. Studying of data reported in scientific literature shows that porous materials with silver applied on the surface as insoluble compounds, such as silver (I) oxide, silver chloride or bromide, are the most advantageous for usage as ESB component in DGR sites for anionic radioiodine species uptake. [ABSTRACT FROM AUTHOR]

Objective: To explore the feasibility of the postoperative diagnostic 131I whole-body planar scans (Dx-WBS) in papillary thyroid cancer (PTC) patients, and to clarify its value for accurate staging, risk stratification, and postoperative radioactive iodine (RAI) treatment management. Design: Retrospective study from 2015 to 2021. Setting: A total of 1294 PTC patients in the tertiary referral hospital. Participants: Patients with differentiated thyroid cancer who underwent total/subtotal thyroidectomy were included. Patients with non-PTC pathological type, non-first RAI treatment, and incomplete data such as Dx-WBS and postablation WBS (Rx-WBS) were excluded. Methods: The diagnostic efficacy of Dx-WBS was calculated with Rx-WBS as the reference. All patients were initially staged by the 8th edition of TNM staging, and risk stratification was performed based on clinical and pathological information. After Dx-WBS, the risk stratification was re-evaluated, and management was reconfirmed. Results: The detection rates of Dx-WBS for residual thyroid, cervical lymph nodes, upper mediastinal lymph nodes, lung, and bone distant metastasis were 97.6%, 78.3%, 82.1%, 66.7%, and 61.2%, respectively. The risk stratification of 113 patients (8.7%) changed after Dx-WBS, of which 107 patients changed from low to intermediate risk, 2 from low to high risk, and 4 from medium to high risk. A total of 241 patients (18.6%) adjusted the RAI regimen after Dx-WBS. Conclusion: This study confirms the diagnostic efficacy of the postoperative Dx-WBS in PTC patients and the value of Dx-WBS in accurately assessing risk stratification, as well as assisting in determining RAI treatment. [ABSTRACT FROM AUTHOR]

The Cu2O/Cu modified shungite (ShC) absorbent (Cu2O/Cu-ShC) was synthesized by hydrothermal method, benefiting from the mineral backbone and Cu2O/Cu particles, Cu2O/Cu-ShC can remove ~ 96% of I− within 60 min, the batch experiments showed that the I− adsorption process follows pseudo-second-order model and Langmuir model with maximum adsorption capacity of 10.99 mg/g. The high binding affinity between Cu+ and I− contributes effective removal of I− and excellent selectivity at high concentrations of competing ions. This work highlights the feasibility of Cu2O/Cu-ShC for the radioactive iodine separation, and provides a promising sorbent material for large-scale purification of radioactive iodine anions in wastewater. [ABSTRACT FROM AUTHOR]

A HKUST-1 derivative composite based on LDH was synthesized to efficiently adsorb iodide anions in aqueous solutions. Specifically, Cu/Al-LDH, HKUST-1, HKUST-1@Cu/Al-LDH, Cu/Al-CLDH, Cu-C and Cu2O@Cu/Al-CLDH were synthesized and characterized. HKUST-1@Cu/Al-LDH kept the desirable characteristics of both Cu/Al-LDH and HKUST-1. Cu2O@Cu/Al-CLDH maintained the morphology of HKUST-1@Cu/Al-LDH, with its iodine anions absorption mechanism being chemical adsorption. Cu2O@Cu/Al-CLDH exhibited a significantly higher adsorption capacity than previously reported Cu-based adsorbents, with an adsorption capacity of 240.7 mg g−1 at pH 3, taking about 240 min to reach adsorption equilibrium. Thus, Cu2O@Cu/Al-CLDH is a promising adsorbent for removing iodide anions from aqueous solutions. [ABSTRACT FROM AUTHOR]

The paper describes the structure and iodine adsorption performance of Ag+ ion-exchange 13X molecular sieve (Ag-13X) with a small Si/Al ratio. The Ag-13X has a high specific surface area (408 m2/g) and a large amount of micropore volume (0.18 cm3/g). The Ag-13X presents a strong affinity with I2 and CH3I. The I2 static adsorption capacity of the 26.7% Ag zeolite reached 700 mg/g. The adsorption capacities under 1‰ and 1% CH3I feeds are up to 104.4 mg/g and 131 mg/g, respectively. This study indicates the applicability of Ag-13X in severe nuclear accidents. [ABSTRACT FROM AUTHOR]

Secondary acquired lacrimal duct obstruction (SALDO) is one of the complications of radioiodine therapy. The material was obtained during endoscopic dacryocystorhinostomy with revision of Hasner's valve in patients with PANDO (n = 7) in the distal segments of the nasolacrimal duct and in patients with SALDO (n = 7) after radioactive iodine therapy. The material was stained with hemotoxylin and eosin, alcyan blue, and by Masson method. Morphological and morphometric analyses were performed in semi-automatic mode. The results of histochemical staining of sections were translated into points taking into account the area and optical density (chromogenicity). The differences were considered significant at p < 0.05. It was shown that the nasolacrimal duct sclerosis is significantly lower (p = 0.029) in patients with SALDO than in patients with PANDO while fibrosis in the lacrimal sac is the same in patients of the compared groups. [ABSTRACT FROM AUTHOR]

Purpose: Autonomously functioning thyroid nodules (AFTNs) are treated with iodine-131 (I-131) therapy, which increases the risk of permanent hypothyroidism; however, the risk can be reduced by separately estimating the accumulated activity for the AFTN and extranodular thyroid tissue (ETT). Methods: A quantitative I-123 single-photon emission computed tomography (SPECT)/CT (5 mCi) was performed in one patient with unilateral AFTN and T3 thyrotoxicosis. The I-123 concentrations measured at 24 h were 12.26 µCi/mL and 0.11 µCi/mL in the AFTN and contralateral ETT, respectively. Thus, the I-131 concentrations and radioactive iodine uptake expected at 24 h by 5 mCi of I-131 were 38.59 µCi/mL and 0.31 for the AFTN and 0.34 µCi/mL and 0.007 for the contralateral ETT. The weight was calculated as CT-measured volume multiplied by 1.03. Results: In the AFTN patient with thyrotoxicosis, we administered 30 mCi of I-131, which would maximize the 24-h I-131 concentration in the AFTN (226.86 µCi/g) and maintain a tolerable concentration in the ETT (1.97 µCi/g). The percentage of I-131 uptake at 48 h post I-131 administration was 62.6%. The patient achieved a euthyroid state at 14 weeks and maintained the state until 2 years post I-131 administration with an AFTN volume reduction of 61.38%. Conclusion: The pre-therapeutic planning of quantitative I-123 SPECT/CT may enable a therapeutic window for I-131 therapy, which directs optimal I-131 activity to effectively treat AFTN while preserving the normal thyroid tissue. Key points: Question: Is it feasible for I-123 SPECT/CT to be used for planning of I-131 therapy in an autonomously functioning thyroid nodule (AFTN)? Pertinent findings: The radioactive iodine uptake of the AFTN and extranodular normal thyroid tissue can be accurately estimated using the I-123 quantitative SPECT/CT. Implications for patient care: Patient-tailored I-131 therapy can be possible using the pre-therapeutic I-123 SPECT/CT-based planning in patients with AFTN. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the impact of various factors including radioactive iodine (RAI) activity on the therapeutic response according to the range of serum thyroglobulin (Tg) in patients with papillary thyroid carcinoma (PTC). Methods: A total of 2809 patients were retrospectively enrolled from 24 hospitals. They were divided into four subgroups according to their serum Tg (stimulated Tg, sTg) or anti-Tg antibody (TgAb) levels, measured just before RAI therapy: sTg < 2 ng/mL, 2 ≤ sTg < 10 ng/mL, sTg ≥ 10 ng/mL, and TgAb > 100 IU/mL. The clinicopathologic factors for therapeutic responses, which were classified as acceptable response (AR) or non-AR, were compared in each subgroup. Results: Clinical impact of the pN category on therapeutic response was different among subgroups based on sTg levels (subgroups with sTg < 2 ng/mL (P = 0.057), 2 ≤ sTg < 10 ng/mL (P = 0.032), and sTg ≥ 10 ng/mL (P = 0.001)). The pN category was also a significant factor in the subgroup with TgAb > 100 IU/mL (P = 0.006). The pT category was not associated with therapeutic response regardless of the sTg level. High activities of RAI (≥ 3.70 GBq) were associated with favorable therapeutic responses in only the subgroup with sTg ≥ 10 ng/mL (P = 0.044). Conclusion: Risk factors for response prediction could be repositioned based on the serum Tg before RAI therapy. RAI activity should be determined while considering the serum Tg-aided remnant thyroid or malignant tissues as well as conventional factors. [ABSTRACT FROM AUTHOR]

Purpose: Patients undergoing thyroidectomy for differentiated thyroid cancer (DTC) may require 131-radioactive iodine (RAI) administration for remnant ablation or disease treatment. After ingestion, RAI resides within the gastrointestinal tract potentially leading to mucosal damage and abnormalities in the absorption of levothyroxine (LT4). The aim of this study was to evaluate whether serum FT4 peak, induced by a LT4 challenge, changes according to the LT4 formulation (solid or liquid) in both RAI and non-RAI-treated DTC patients. Methods: This was a monocentric controlled clinical trial, with a parallel two-groups (1:1) randomization of sequence of LT4 formulation. Patients received 200 mcg LT4 orally administered at 08:00 h, in both solid and liquid formulation, at one-week interval, at baseline and after 1, 3, and 6 months from RAI administration. At each time-point, circulating FT4 was evaluated both before LT4 assumption as well as after 1 and 3 h. FT4 increments were evaluated as area under the curve response (AUC). Analogous protocol with the same time-intervals was followed for non-RAI patients. Results: The trial included 29 consecutive DTC patients, nineteen of whom were submitted to RAI. In RAI subjects, we observed an overall significant reduction in serum FT4 increments with the most relevant decrease at the 1-month time-point, (FT4 AUC: 4.46 ± 0.72 (M ± SD) vs 4.07 ± 0.63 in baseline vs 1-month, P = 0.001) without any difference between the two LT4 formulations. No difference in serum FT4 AUC was found in non-RAI subjects. Conclusion: LT4-induced serum FT4 responses are reduced following RAI administration in thyroidectomized DTC patients. [ABSTRACT FROM AUTHOR]

Objective: Albumin–globulin ratio (AGR), which is calculated by dividing serum albumin by serum globulin, is considered as a cancer-related inflammation biomarker. Although the prognosis of many solid cancers has been shown to be associated with AGR, there are no studies to demonstrate the association between the prognosis of thyroid cancer and AGR. The purpose of this study is to reveal the relationship between AGR and overall survival (OS) in patients with thyroid cancer who received radioactive iodine therapy (RIT). Methods: Eighty-eight patients with thyroid cancer who had received RIT for the first time in our institution were included. The values before RIT were adopted as initial measurements for serum albumin, globulin, and thyroglobulin (Tg) and used for analysis. Patients were divided into two groups based on the AGR value. We analyzed the relationship between clinical factors and treatment outcome. Results: The median follow-up period was 92.4 months (range: 30.1–173.9 months). The 5-year OS and progression-free survival (PFS) were 94% and 54%, respectively. Seventeen patients (< 65 years, 8; and ≥ 65 years, 9) died during the follow-up period. Low AGR was significantly associated with OS in both univariate and multivariate analyses (p = 0.0059 and p = 0.0120, respectively). As the 5-year OS was as high as 94%, there was no significant difference in survival rate between the two groups during the first 5 years. However, there seemed to be a remarkable difference in 10 years after the first RIT. On the other hand, Tg was significantly associated with PFS in both univariate and multivariate analyses (p = 0.0016 and p = 0.0441, respectively). In patients under the age of 65, the PFS rate was significantly lower in the low AGR group (p < 0.0001), while there was no difference in PFS rate between the two AGR groups in patients aged 65 years or older. Conclusions: AGR may be used as a prognostic factor in relatively younger patients with thyroid cancer treated with radioiodine, while it may be less useful in the older. Overall, it may be an independent prognostic factor for long-term survival in those with thyroid cancer. [ABSTRACT FROM AUTHOR]

Purpose: We investigated whether response classification after total thyroidectomy and radioactive iodine (RAI) therapy could be affected by serum levels of recombinant human thyrotropin (rhTSH)-stimulated thyroglobulin (Tg) measured at different time points in a follow-up of patients with papillary thyroid carcinoma (PTC). Methods: A total of 147 PTC patients underwent serum Tg measurement for response assessment 6 to 24 months after the first RAI therapy. Serum Tg levels were measured at 24 h (D1Tg) and 48–72 h (D2-3Tg) after the 2nd injection of rhTSH. Responses were classified into three categories based on serum Tg corresponding to the excellent response (ER-Tg), indeterminate response (IR-Tg), and biochemical incomplete response (BIR-Tg). The distribution pattern of response classification based on serum Tg at different time points (D1Tg vs. D2-3Tg) was compared. Results: Serum D2-3Tg level was higher than D1Tg level (0.339 ng/mL vs. 0.239 ng/mL, P < 0.001). The distribution of response categories was not significantly different between D1Tg-based and D2-3Tg-based classification. However, 8 of 103 (7.8%) patients and 3 of 40 (7.5%) patients initially categorized as ER-Tg and IR-Tg based on D1Tg, respectively, were reclassified to IR-Tg and BIR-Tg based on D2-3Tg, respectively. The optimal cutoff values of D1Tg for the change of response categories were 0.557 ng/mL (from ER-Tg to IR-Tg) and 6.845 ng/mL (from IR-Tg to BIR-Tg). Conclusion: D1Tg measurement was sufficient to assess the therapeutic response in most patients with low level of D1Tg. Nevertheless, D2-3Tg measurement was still necessary in the patients with D1Tg higher than a certain level as response classification based on D2-3Tg could change. [ABSTRACT FROM AUTHOR]

Purpose: Histologic and pTNM classification of differentiated thyroid cancer (DTC) is mandatory to assess risk of relapse, risk of death, and radioactive iodine administration. The impact of an expert central review of external pathology reports has not yet been reported. Methods: Monocentric retrospective study to evaluate the difference between initial and second-opinion histopathologic diagnosis for DTC patients referred for post-operative radioactive iodine administration between January 2014 and December 2016. We evaluated major discordance (change of diagnosis from malignant to benign or in main histological subtype or a description of aggressive pathological subtypes), minor discordance (change in histological subtype or description of an aggressive component, multifocality or extrathyroidal extension), and change in ATA classification. Results: A second-opinion histological diagnosis was available for 199 patients. A major discordance was observed in 42 (21%) cases (changes in malignancy in 4 cases, changes in main histological subtype in 22, changes in aggressive pathology variants of PTC in 16). One hundred and four minor discordances were observed regarding 92 patients. These histopathological changes led to changes in the ATA 2015 risk stratification classification in 61 (31%) of cases. There were no predictive factors of major/minor histologic changes or ATA risk stratification changes. Conclusion: Expert central review of pathology has an impact on the 2015 ATA risk stratification classification that can lead to changes in the management of patients with differentiated thyroid cancer. [ABSTRACT FROM AUTHOR]

Effect of 2-hydroxypropyl α-cyclodextrin (α-HPCD) on the iodine adsorption onto activated carbon (AC) was investigated. The iodine sorption efficiency increased with the sorption time, but the rate of increase in the sorption efficiency varied depending on the α-HPCD concentration. As a result, there were significant differences of up to 3 times in sorption efficiency between the α-HPCD concentrations in the sorption time of 3 days. There was almost no difference in the sorption efficiency between the α-HPCD concentrations in the sorption time of 10 days. It is considered that the sorption speed increased, because the molecules number increases and the affinity of iodine for AC increased as the iodine is included into α-HPCD. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the influence of H2RAs to the 24-h I-131 uptake in the thyroid gland. Material and Methods: A prospective study with quasi-experimental pre- and post-study design was done. Subjects with normal fT4 level who fulfilled the inclusion criteria were selected. All subjects received 0.2 mCi of I-131 orally, and the thyroid uptake calculations were performed at 24 h later. The same procedure was performed 4 weeks later. All of the subjects were asked to consume H2RAs 1 h before the administration of I-131 of the second procedure. Both 24-h thyroid uptakes were statistically analysed. Results: A total of 14 subjects were enrolled in this study. Most of them were women (78%) with an average age of 37.6 years old (range: 20–55). This study showed a median of 24-h thyroid uptake of I-131 before and after H2-receptor antagonist of 20.6% (range: 11.1–57.8%) and 16.7% (range: 8.1–39.4%) respectively. Conclusion: H2-receptor antagonist caused a significance reduction of 24-h I-131 uptake value in the thyroid gland. [ABSTRACT FROM AUTHOR]

Purpose: After the accidents of nuclear power plants at Chernobyl and at Fukushima, huge amounts of radioactive iodine were released into the atmosphere. Methods: We reviewed data on the health consequences of these accidents with a focus on thyroid consequences. Results: Among the 2 million children who were living in highly contaminated regions in Belarus, Ukraine and Russia, 7000 cases of thyroid cancer had occurred in 2005. This is the most significant radiation-induced consequence of the Chernobyl accident. The increased incidence of thyroid cancer observed in adult population who lived in these highly contaminated regions is at least in major part related to screening and it is not possible to individualize among these thyroid cancers those that are potentially caused by radiation exposure. For populations who lived outside these regions at the time of the accident, there is no detectable consequence of the radiation exposure on the thyroid gland. Among children who lived nearby the Fukushima power plant in 2011, there is currently no evidence of an increased incidence of thyroid cancer. Ultrasonography screening in these individuals detected a number of thyroid cancers that are probably not related to the accident. Because thyroid cancer is frequent, studies have been carried out to distinguish radiation-induced from their sporadic counterparts, and genomic signatures might be helpful. Conclusions: The consequences of the Chernobyl accident clearly demonstrate that populations living nearby a nuclear power plant should be protected in case of accident by sheltering, food restrictions and prophylaxis of thyroid irradiation by potassium iodine administration, if the predicted estimated dose to the thyroid gland of children might be >50 mGy. These countermeasures should be applied in priority to children, adolescents and pregnant women; they are safe and effective. [ABSTRACT FROM AUTHOR]

An iodine immobilization matrix, the AgI–Ag2O–TeO2 glass system, was developed. The effects of different additives, i.e., Bi2O3, Al2O3, and PbO, on performance were investigated. In an ambient atmosphere and at 800 °C, the melting of the glass precursor mixture was completed after 1.0 h, without significant loss of the constituent elements of the glass except for aluminum. The loading of iodine in the matrix was approximately 11–15% by weigh, excluding oxygen. The normalized releases of all the elements from the matrix were below the order of 10−1 g/m2, which satisfies US regulation (2 g/m2). Additionally, each additive had a different effect on the glass system, and their effects on element release from the matrix were clarified. [ABSTRACT FROM AUTHOR]

The 2015 American Thyroid Association (ATA) guideline have suggested modifications in the risk stratification (RS) for differentiated thyroid cancer (DTC) patients, introduced the concept of dynamic risk stratification (DRS) and redefined the role of radioactive iodine (RAI) in treatment algorithm. The aim of this retrospective audit was to assess the practical implications of these modifications in management of DTC. Methods: A total of 138 DTC patients were stratified according to ATA 2009 and 2015 guidelines into low (LR), intermediate (IR) and high (HR) risk groups. Change in RS and in intention of RAI use was calculated. Deviation in administered RAI dosage from the guidelines was assessed. 1-year follow-up data was audited to assess how the DRS modified the initial risk estimate. Results: A total of 11.6% of patients changed their RS categories in 2015 guidelines. A total of 10.1% got upstaged to HR, and 1.4% got downstaged to LR. In 2.17% of patients' intention of RAI use changed to remnant ablation from adjuvant therapy and 65% of the LR patients won't require any RAI therapy. A total of 26.7% of patients had received significantly more RAI dosage according to ATA 2015. At 1-year follow-up according to DRS 84% of LR, 75% of IR and 44% of HR patients showed excellent response (ER). Conclusion: More patients changed RS to HR than to LR. Intention of RAI use changed in only a small number of patients. Significantly higher dosage of RAI is being administered to patients in current practice. The effect of DRS in modifying the initial RS was most prominent in IR, with most showing ER to initial therapy. [ABSTRACT FROM AUTHOR]

Treatment of differentiated thyroid cancer often involves administration of radioactive iodine (I-131) for remnant ablation or adjuvant therapy. However, there is morbidity associated with I-131 therapy, which can result in both acute and chronic complications. Currently, there are no approved radioprotectors that can be used in conjunction with I-131 to reduce complications in thyroid cancer therapy. It is well known that the damaging effects of ionizing radiation are mediated, in part, by the formation of reactive oxygen species (ROS). A potent scavenger of ROS, Mn(III)meso-tetrakis(N–n-butoxyethylpyridinium-2-yl)porphyrin (MnTnBuOE-2-PyP), has radioprotective and anti-tumor effects in various cancer models including head and neck, prostate, and brain tumors exposed to external beam radiation therapy. Female C57BL/6 mice were administered I-131 orally at doses of 0.0085–0.01 mCi/g (3.145 × 105 to 3.7 × 105 Bq) of body weight with or without MnTnBuOE-2-PyP. We measured acute external inflammation, blood cell counts, and collected thyroid tissue and salivary glands for histological examination. We found oral administration of I-131 caused an acute decrease in platelets and white blood cells, caused facial swelling, and loss of thyroid and salivary tissues. However, when MnTnBuOE-2-PyP was given during and after I-131 administration, blood cell counts remained in the normal range, less facial inflammation was observed, and the salivary glands were protected from radiation-induced killing. These data indicate that MnTnBuOE-2-PyP may be a potent radioprotector of salivary glands in thyroid cancer patients receiving I-131 therapy. [ABSTRACT FROM AUTHOR]

The radioactive iodine volatilization inhibition of cyclodextrin and the influence of radiation on this effect were evaluated by observing the change in the radioactive iodine-131 (131I) retention rate in an aqueous solution containing cyclodextrin as a function of time. The retention rate was found to be 1/3–1/4 that of an aqueous solution without cyclodextrin. The 131I retention rates remained consistent even after exposure to high doses of radiation up until 30,000 Gy. Cyclodextrin was thus found to be effective for inhibiting the volatilization of radioactive iodine. [ABSTRACT FROM AUTHOR]

The specific emission rates of iodine isotopes into the atmosphere during normal operation of European and Russian NPPs with different types of reactor facilities were analyzed. The probability distributions for the specific parameters are asymmetric, and their median values tend to decrease. Three categories of NPPs were distinguished: those with the best, worst, and stable practice of the 131I emission. The current global atmospheric release of 129I from all the NPPs in the world is estimated at 0.8 kBq year−1. With an increase in the total installed NPP capacity to 632 GW, the global release of 129I from the NPP emissions will increase to 1.4 kBq year−1, which is two times lower than the rate of natural production of this nuclide from atmospheric Xe isotopes under the action of cosmic rays. Based on the measurements performed at separate Russian NPPs, the contribution of the aerosol and gaseous iodine forms to the total volume activity of the released iodine isotopes was determined. Under the conditions of normal NPP operation, gaseous iodine compounds make the prevalent contribution to the radioiodine emissions (65–85%). [ABSTRACT FROM AUTHOR]

Radioactive iodine treatment is useful for ablating remnant thyroid tissue and metastasis of well-differentiated thyroid cancer with long-lasting effects. A scintigraphy after radioactive iodine treatment is a major imaging modality for detecting metastasis and assessing the management of metastasis. However, caution is required when reading the scan due to potential false-positive findings. In this study, scintigraphy and single-photon emission computed tomography/computed tomography images after radioactive iodine treatment revealed a physiological uptake of radioactive iodine due to lacrimal secretion around an artificial eyeball; such findings have not been reported previously. [ABSTRACT FROM AUTHOR]

The results of estimating the activity of the aerosol form and gaseous compounds of iodine isotopes in the ventilation system of the IVV-2M reactor facility are presented. The contribution of aerosol and gaseous forms of iodine to the total volumetric activity was simultaneously determined. Criteria of homogeneity of sorbed iodine compounds are determined on the basis of analysis of the dependence of the activity distribution in the layers of a multilayer filter. The study made it possible to determine the form in which radioactive iodine enters the space above the surface of the coolant of the water-moderated water-cooled pool-type research reactor. It is shown that the volumetric iodine activity in the air of the ventilation system of the reactor facility is generally determined by hardly sorbed gaseous compounds. [ABSTRACT FROM AUTHOR]

Radioactive iodine (RAI) therapy for differentiated thyroid cancer has been successfully used for more than 70 years. However, there is still plenty of controversy surrounding the use and doses of radioiodine. There is insufficient evidence to answer the questions. Recent American Thyroid Association (ATA) guidelines seem to favor low-dose RAI, based on recent clinical trials and meta-analyses. However, long-term follow-up data remains limited, and there are additional factors we should consider that might affect the efficacy of RAI therapy. Therefore, until sufficient data are available, it is necessary to remain cautious about determining RAI doses by considering multiple patient-specific variables. [ABSTRACT FROM AUTHOR]

The decomposition of molecular iodine by hydrogen peroxide and sodium hydroxide was kinetically studied in aqueous solutions at ambient temperature. To obtain an effective decomposition rate constant under experimental conditions, the concentration of triiodide ions was measured over time instead of that of molecular iodine. Overall, sodium hydroxide was regarded as a more effective decomposer than hydrogen peroxide. As demonstrated in the present study, existing methodologies can be simplified by grouping relevant reaction steps in order to estimate iodine volatility under a severe accident condition for a nuclear power plant. [ABSTRACT FROM AUTHOR]

Purpose: In recent years, anti-Mullerian hormone (AMH) has been considered a reliable index of ovarian reserve. There are few data on AMH values in thyroid cancer. The aim of this study was to evaluate AMH levels in pre-menopausal women with a history of low-risk thyroid cancer.Methods: Thirty-four women (aged 40.7 ± 6.7 years) were studied 7.1 ± 0.9 years after surgery and at least one RAI treatment. A group of 23 thyroid cancer women (41.6 ± 7.4 years) who had undergone only thyroidectomy served as controls. AMH, follicle-stimulating hormone (FSH) and estradiol were assayed on days 2-3, and prolactin and progesterone levels on days 21-24 of the menstrual cycle.Results: Pregnancy (RAI group 62%; control group 61%) and miscarriage rates (18% and 26%) were similar. AMH levels were similar in the RAI (10.7 ± 1.7 pmol/l) and control (17.5 ± 4.7 pmol/l) groups. Regular menses were reported in 41% and 52% of RAI and control subjects, respectively. Non-ovulatory cycles were noted in 26% and 35% of RAI and control women, respectively. AMH levels were found to be negatively correlated with age (RAI group P = 0.0003; control group P = 0.0001) and FSH, and positively correlated with progesterone, but not with the other hormonal parameters.Conclusions: AMH should replace FSH in the evaluation of gonadal reserve in pre-menopausal thyroid cancer women. At present, age is the only predictor of AMH levels. About one out of two women with a history of thyroid cancer suffers from menstrual dysregulation, but infertility must be considered a low risk. [ABSTRACT FROM AUTHOR]

Single-photon emission computed tomography with integrated computed tomography (SPECT/CT) systems has been applied in a wide range of clinical circumstances, and differentiated thyroid cancer (DTC) is one of the most important indications of SPECT/CT imaging. In the treatment of DTC, SPECT/CT images have been reported to have many advantages over conventional planar whole-body scintigraphy based on its precise localization and characterization of abnormal foci of radioactive iodine (RAI) accumulation, influencing the staging, risk stratification, and clinical management as well as reader confidence. On the other hand, SPECT/CT has limitations including additional radiation exposure from the CT component, additional imaging time, and cost-related issues. Each SPECT/CT image acquired at different time points throughout the management of DTC may have a different clinical meaning and significance. This review article addresses the clinical usefulness of RAI SPECT/CT images acquired during the pre-ablation period, post-therapy period, and long-term follow-up period, respectively. [ABSTRACT FROM AUTHOR]

Prostate-specific membrane antigen (PSMA), a type II transmembrane glycoprotein receptor, is highly expressed in prostate cancer and in the tumor neovasculature of colon, breast, and adrenocortical tumors. Here, we analyzed PSMA expression in the neovasculature of various thyroid cancer subtypes and assessed whether PSMA expression is correlated with aggressive behavior. From a prospectively maintained database, we evaluated 91 samples from 68 patients, including 37 primary differentiated thyroid cancers (DTCs) [11 classic papillary (cPTC), 9 follicular-variant (FvPTC), 11 follicular (FTC), 6 radioactive iodine-refractory (RAIR)], 5 anaplastic (ATC) carcinomas, 9 distant and 12 lymph node metastases, 21 benign thyroid nodules, and 7 normal thyroid specimens. Formalin-fixed paraffin-embedded tissue blocks were immunostained for vascular endothelial marker CD31 and PSMA with proper controls. PSMA expression was not detected in normal thyroid tissue. DTC tumors demonstrated a significantly higher PSMA expression, in regard to both intensity and percentage of vessels stained, than benign tumors ( p < 0.001). Among the histologic subtypes, cPTC, FTC, and RAIR carcinomas demonstrated the highest percent of moderate to strong PSMA staining. PSMA expression was seen more frequently in specimens from distant metastases (100%) compared with specimens from only lymph node metastases (67%). PSMA is significantly overexpressed in the neovasculature of DTCs compared with normal and benign thyroid nodules specifically with increased expression in RAIR carcinomas and distant metastases. PSMA should be further explored as a novel therapeutic target for metastatic and RAIR carcinomas. [ABSTRACT FROM AUTHOR]

We evaluated the effect of the antioxidant N-acetyl- l-cysteine (NAC) on the levels of reactive oxygen species (ROS), DNA double strand breaks (DSB) and micronuclei (MN) induced by internal and external irradiation using a rat thyroid cell line PCCL3. In internal irradiation experiments, ROS and DSB levels increased immediately after I addition and then gradually declined, resulting in very high levels of MN at 24 and 48 h. NAC administration both pre- and also post-I addition suppressed ROS, DSB and MN. In external irradiation experiments with a low dose (0.5 Gy), ROS and DSB increased shortly and could be prevented by NAC administration pre-, but not post-irradiation. In contrast, external irradiation with a high dose (5 Gy) increased ROS and DSB in a bimodal way: ROS and DSB levels increased immediately after irradiation, quickly returned to the basal levels and gradually rose again after >24 h. The second phase was in parallel with an increase in 4-hydroxy-2-nonenal. The number of MN induced by the second wave of ROS/DSB elevations was much higher than that by the first peak. In this situation, NAC administered pre- and post-irradiation comparably suppressed MN induced by a delayed ROS elevation. In conclusion, a prolonged ROS increase during internal irradiation and a delayed ROS increase after external irradiation with a high dose caused serious DNA damage, which were efficiently prevented by NAC. Thus, NAC administration even both after internal or external irradiation prevents ROS increase and eventual DNA damage. [ABSTRACT FROM AUTHOR]

Purpose: Thyroid concentrates radioactive iodine by sodium-iodide symporter; this is used for treating hyperthyroidism and thyroid cancer. Pancreas expresses NIS and radioactive iodine uptake may damage pancreatic beta-cells and predispose patients to type 2 diabetes. The aim of this study was to determine whether radioactive iodine is associated with glucose metabolism in thyroidectomized rats. Methods: Forty male Wistar rats were divided into four groups ( n = 10/each); control, thyroidectomized, thyroidectomized-treated with 131-I (TX+I), and thyroidectomized-treated with 131-I and l-thyroxine (TX+I+T). At the end of study, serum fasting glucose, insulin, thyroid-stimulating hormone, and free tetraiodothyronine were measured, intraperitoneal glucose tolerance test was performed, and homeostasis model assessment-insulin resistance was calculated. In in vitro experiments, glucose-stimulated insulin secretion from pancreatic islets and sodium-iodide symporter mRNA expression in thyroid and islets were determined. Results: Compared to control group, free tetraiodothyronine was lower by 41 and 77% and thyroid-stimulating hormone was higher by 36 and 126% in thyroidectomized and TX+I groups, respectively. Compared to controls, rats in TX+I group had glucose intolerance as assessed using the area under curve of intraperitoneal glucose tolerance test (12,376 ± 542 vs. 20,769 ± 1070, P < 0.001) and l-thyroxine replacement therapy restored the value (14,286 ± 328.24) to near normal. Fasting insulin and homeostasis model assessment-insulin resistance were comparable in all groups, however fasting glucose was higher in TX+I group. In in vitro experiments, glucose-stimulated insulin secretion from islets did not differ between groups. Conclusion: Radioactive iodine therapy per se had no effect on glucose metabolism, just intensified thyroid hormone deficiency and the alterations on glucose metabolism in thyroidectomized rats. l-thyroxine therapy restored the glucose intolerance observed in radioactive iodine-treated thyroidectomized rats. [ABSTRACT FROM AUTHOR]

Sorption of CH I and I from water vapor-air medium onto SiO-C (2 wt %) composite material and a mixture of SKT-3I with SiO-Cu (10 wt %) was studied. SKT-3I shows high performance in sorption of I and CH I. The degree of localization of I and CH I exceeds 99.99% at ~60°С and gas phase-sorbent contact time τ of ~0.45 s. The degree of sorption of I and CH I onto the SiO-C (2 wt %) composite material under similar conditions does not exceed ~87 and ~8%, respectively. Experiments on I and CH I sorption onto mechanical mixtures of SiO-Cu and SKT-3I in the weight ratio varied from 1: 4 to 1: 1 showed that the degree of the I and CH I sorption at ~60°С and τ ~0.45 s exceeded 99.95 and 99.0%, respectively. The scheme of layer-by-layer arrangement of SiO-Cu and SKT-3I in the column was examined. It shows promise for use in AUI-1500VM filters in ventilation systems of nuclear power plants. [ABSTRACT FROM AUTHOR]

Prophylactic neck dissection (PND) for papillary thyroid carcinoma (PTC) is controversial. Our aim was to assess current levels of evidence (LE) according to the Oxford Centre for Evidence-based Medicine () regarding the oncologic benefits of PND. Data were analyzed via MEDLINE keywords: PTC, differentiated thyroid carcinoma, PND, central lymph node metastases, central compartment, recurrence-free survival. There was conflicting evidence regarding the rate of reoperation for recurrence, with some studies showing a lower rate after PND with increased recurrence-free survival and a higher rate of undetectable pre- and post-ablation thyroglobulin levels (LE 4), whereas other studies did not show a difference (LE 4). Only one study (LE 4) showed improved disease-specific survival with PND. PND may improve recurrence-free survival, although this is supported by only a low LE. Current recommendations can only be based on low-level evidence. [ABSTRACT FROM AUTHOR]

Ag/13X adsorbents were synthesized, characterized and tested for decontamination of gaseous effluents from I at high temperatures. X-ray diffraction patterns showed that the Ag/13X samples maintained a stable structure after calcined at 650 °C for 2 h. The decontamination factors achieved with 15 % Ag/13X and 20 % Ag/13X adsorbents for I were nearly close to 10 at 650 °C. In addition, 15 % Ag/13X had a stable performance for removal of I at 550 and 650 °C, even after calcined at 550 and 650 °C for over 10 h, which might be suitable for future potential use during nuclear reactor operation or in the case of nuclear accidents. [ABSTRACT FROM AUTHOR]

Sorafenib (Nexavar®) is the first tyrosine kinase inhibitor to be approved for the treatment of radioactive iodine (RAI)-refractory differentiated thyroid carcinoma (DTC). In the pivotal phase III DECISION trial in patients with RAI-refractory, locally advanced or metastatic DTC, oral sorafenib 400 mg twice daily significantly prolonged median progression-free survival (PFS) relative to placebo. The PFS benefit of sorafenib over placebo was evident in all pre-specified clinical and genetic biomarker subgroups, and neither BRAF nor RAS mutation status was predictive of sorafenib benefit for PFS. The objective response rate was significantly higher in patients receiving sorafenib than in those receiving placebo; all objective responses were partial responses. The overall survival benefit of sorafenib is as yet unclear, with no significant benefit observed at the time of primary analysis or at 9 months following the primary analysis. Overall survival was possibly confounded by the crossover of patients in the placebo group to sorafenib upon disease progression. The adverse events associated with sorafenib in the DECISION trial were consistent with the known tolerability profile of the drug, with hand-foot skin reaction, diarrhea, and alopecia reported most commonly. Most treatment-emergent adverse events were grade 1 or 2 in severity and occurred early in treatment. However, a high proportion of patients discontinued sorafenib therapy or required dose reductions or interruptions because of toxicity. Although final overall survival data are awaited, current evidence suggests that sorafenib is a promising new treatment option for patients with RAI-refractory, metastatic DTC. [ABSTRACT FROM AUTHOR]