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1.
Reconstruction of residents' thyroid equivalent doses from internal radionuclides after the Fukushima Daiichi nuclear power station accident.
Ohba, T, Ishikawa, T, Nagai, H, Tokonami, S, Hasegawa, A, Suzuki, G
Scientific reports. 2020;(1):3639
Abstract
There is concern among residents that their children might suffer from thyroid cancer in the near future after the Fukushima Daiichi nuclear power station (FDNPS) accident. However, the demographic and geographical distribution of thyroid equivalent doses was not thoroughly evaluated, and direct thyroid measurements were conducted only for 1,200 children, whose individual thyroid doses were assessed on the basis of those measurements accounting for the dynamics of radioiodine intake. We conducted hierarchical clustering analyses of 100 or 300 randomly sampled behavioural questionnaire sheets of children from each of seven municipalities in the evacuation area to reconstruct evacuation scenarios associated with high or low exposures to plumes. In total 896 behaviour records in the Fukushima Health Management Survey were analysed to estimate thyroid equivalent doses via inhalation, using a spatiotemporal radionuclides concentration database constructed by atmospheric dispersion simulations. After a decontamination factor for sheltering and a modifying factor for the dose coefficient-to reflect lower iodine uptake rate in Japanese-were applied, estimated thyroid equivalent doses were close to those estimated from direct thyroid measurement. The median and 95th percentile of thyroid equivalent doses of 1-year-old children ranged from 0.6 to 16 mSv and from 7.5 to 30 mSv, respectively. These results are useful for future epidemiological studies of thyroid cancer in Fukushima.
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2.
The effect of intake of sausages fortified with β-CD-I2 complex on iodine status and thyroid function: A preliminary study.
Polumbryk, M, Kravchenko, V, Pasichnyi, V, Omelchenko, C, Pachitskaya, I
Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS). 2019;:159-163
Abstract
The present study evaluated influence of boiled sausages consumption fortified with β-CD-I2 on the urinary iodine excretion (UIE) level of volunteers. Median urinary UIE level was increased from 58.02 (24.0-175.4) μg/L to 110.6 (20.5-231.6) μg/L during 10 days. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were determined by radio immunoassay analysis. As it was expected, intake of sausages fortified with β-CD-I2 resulted in rise of FT4 level from 1.1 (0.95-1.25) to 1.23 (1.07-1.63) ng/dL, whereas TSH level decreased from 1.53 (0.47-3.37) mIU/L to 1.1 (0.51-3.17) mIU/L. A dynamic gastrointestinal model in vitro was used in order to determine possibility of 3,5-diiodotyrosine (DIT) formation during consumption of the fortified sausages. The DIT concentration was determined by HPLC-MS method and was found to be 0.38 ng/mL in sausage dialyzate. These findings indicate that β-CD-I2 introduction as an iodine carrier in boiled sausages may help to improve iodine status and to control organic iodine species concentration.
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3.
The Influence of the Manner of Performing the Thyroid Ultrasound Examination on the Reliability of the Assessment of the Thyroid Size in School-Aged Children.
Zygmunt, A, Adamczewski, Z, Zygmunt, A, Karbownik-Lewinska, M, Lewinski, A
Hormone research in paediatrics. 2017;(6):368-376
Abstract
BACKGROUND/AIMS: Goitre incidence in school-aged children evaluated using ultrasonography is one of the essential indicators of iodine intake in a given area. The aim of the study was to examine what the difference is between the volume of the thyroid gland measured in the supine and sitting position and to determine the intra-observer, inter-observer, and inter-position variations. METHODS The survey was conducted among 87 children (56 girls and 31 boys aged 7-13 years, mean age 10.44 ± 1.72 years). RESULTS The thyroid volume measured in a sitting position was significantly lower than that measured in the supine position. The intra-observer variations for the total thyroid volume equalled 9.56-9.65%. The inter-observer variations were significantly higher and amounted to 34.5-35.7%. CONCLUSIONS The way in which ultrasound evaluation is performed is important for the analysis of the results. It is crucial to aim for the smallest inter-observer variation, which can be achieved by strictly defining the methods of the thyroid measurement and comparing one's measuring techniques with the reference method. The use of standards in ultrasound evaluation performed in the supine position, as well as the use of standards without a strict determination of the study method, can lead to erro-neous conclusions.
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4.
Thyroid function and metabolic risk factors in obese youth. Changes during follow-up: a preventive mechanism?
Bouglé, D, Morello, R, Brouard, J
Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association. 2014;(9):548-52
Abstract
OBJECTIVES High TSH levels often observed in overweight subjects are associated with metabolic risk. Thyroid hormones which are involved in fat and carbohydrates metabolism are more rarely studied; their blood levels were measured to more precisely explain the relationships between thyroid function and obesity, in healthy overweight youth. This correlation was studied at baseline and during follow-up of some patients. MATERIALS/METHODS Data collected were BMI and BMI z score, thyroid hormones (TSH, fT4, fT3), fasting blood glucose, HOMA-IR, lipids (triglycerides, HDL and LDL cholesterol), transaminase activity, fibrinogen, leptin, IGF-I; body composition (biphotonic absorptiometry). Data collected in a sample of the group after 6-18 months of medical intervention could also be studied. RESULTS At baseline, 13% of the 528 obese subjects (55% girls; 11.3±2.4 years, range 4.1-17.9; BMI z score: 5.4±2.4) had TSH>4mUI/l; fT3 levels were associated with age and transaminase activity; using multivariate regression analysis, with z-score and age as covariates, fT4 showed correlations with TSH, insulin, HOMA IR, blood lipids, and fibrinogen. No correlations were found with leptin, iodine excretion, IGF-I.In 79 patients followed for 52±15 wk (45% girls; age range 8-18.3 years), univariate regression showed a positive correlation between changes in TSH and HOMA-IR, and between changes in fT4 and HDL. Multivariate regression analysis with z score as covariate showed that baseline TSH was associated with negative changes in HOMA-IR. CONCLUSIONS Increased TSH may be predictive of a decrease in insulin resistance, it should be measured with thyroid hormones; fT4 was associated with a low metabolic risk. Changes in thyroid function could protect against the occurrence of obesity-associated metabolic diseases.
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5.
Thyroid function in children with epilepsy treated with sodium valproate monotherapy: a prospective study.
Attilakos, A, Katsarou, E, Prassouli, A, Mastroyianni, S, Voudris, K, Fotinou, A, Garoufi, A
Clinical neuropharmacology. 2009;(1):32-4
Abstract
OBJECTIVE Studies on the effects of sodium valproate (VPA) on thyroid hormone balance in patients with epilepsy are conflicting. The aim of this study was to prospectively evaluate the changes in thyroid profile in children with epilepsy treated with VPA monotherapy. METHODS Serum thyroxine, free thyroxine, triiodothyronine, and thyrotropin (TSH) levels were evaluated in 30 children with epilepsy, before and at 6, 12, and 24 months of VPA monotherapy. RESULTS All children had normal thyroid function before the initiation of VPA treatment. Serum VPA concentrations remained within the therapeutic range (50-100 mg/L) during the period of study. Thyroxine and free thyroxine levels were significantly decreased, whereas TSH levels were significantly increased at 6, 12, and 24 months of VPA therapy. Triiodothyronine levels were significantly decreased only at 24 months of therapy. Thirteen children (43.3%) at 6 months, 14 children (46.6%) at 12 months, and 15 children (50%) at 24 months of treatment had TSH values greater than 5 mIU/mL. Normal serum TSH levels were restored in all 8 children examined at 3 months after withdrawal of medication. CONCLUSIONS Valproate monotherapy may cause significant alteration in thyroid profile in children with epilepsy, occurring early in the course of treatment and persisting as long as VPA is initiated. Therefore, it may be useful to measure serum thyroid hormone concentrations routinely in children with epilepsy taking VPA. Further prospective studies are required to determine the mechanisms and risk factors for development of thyroid disturbance in children treated with VPA monotherapy.
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6.
Second-generation thyrotropin receptor antibodies assay and quantitative thyroid scintigraphy in autoimmune hyperthyroidism.
Giovanella, L, Ceriani, L, Ghelfo, A
Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme. 2008;(7):484-6
Abstract
Graves' disease (GD) is characterized by circulating TSH receptor antibodies (TRAb), and so-called hyperthyroid autoimmune thyroiditis (H-AIT) generally shows negative TRAb results with first-generation assays. However, a positive titer was observed in up to 13% of patients with euthyroid or hypothyroid autoimmune thyroiditis (AIT) by second-generation TRAb assays, and a larger increase is expected in hyperfunctioning forms. A thyroid 99mTc-pertechnetate uptake (TcTUs) cutoff of 2% previously was shown to accurately discriminate between GD and H-AIT. Here we evaluated the relationship between second-generation TRAb assays and TcTUs in 139 patients with untreated autoimmune hyperthyroidism. An increase in TRAb levels was found in 114 of 139 patients (82%). All patients with TcTUs >2% and 66% of those with lower values had positive TRAb measurements. When the cutoff was increased to 5.9 U/l, positive TRAb occurred in 92.6% of those having higher TcTUs and in 1.4% of those with lower TcTUs. TRAb levels significantly increased in patients with TcTUs higher than 2% as compared with those having lower values, while no differences occurred in patients with TcTUs ranging from 0 to 1%, from 1.1 to 1.5%, or from 1.6 to 2%. A significant relationship between TRAb and TcTUs (as well as fT3, fT4, and thyroid volume) was found. TcTUs, fT4, fT3, and thyroid volume significantly increased in patients with positive TRAb (cutoff 1.5 U/l) compared with those testing negative. Our data indicate that a large proportion of patients with hyperthyroidism and hypoechoic thyroid, including those previously diagnosed as having H-AIT, actually have circulating TRAb. TRAb levels predicate the degree of iodine uptake (as measured by TcTUs) and thyroid hyperfunction. The role of baseline TRAb measurement by second-generation assays to predict patients' outcome needs to be further evaluated and compared with TcTUs in prospective studies.
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7.
Intraoperative parathyroid hormone measurement in thyroidectomized patients: preliminary report.
Lewandowicz, M, Kuzdak, K, Pasieka, Z
Endocrine regulations. 2007;(1):29-34
Abstract
BACKGROUND Hypocalcemia is the most frequent complication after thyroid surgery. Intraoperative measurement of parathormone levels (ioPTH) in patients undergoing thyroid surgery has been recently described as an accurate method of predicting postoperative parathyroid dysfunction. The aim of the study was to evaluate utility of ioPTH and parathormone level measured 24 hours after surgery (24PTH) as prognostic factors of hypoparathyroidism and consequent hypocalcemia. SUBJECTS AND METHODS Fifty-four patients (50 females and 4 males) underwent 55 operations: subtotal thyroidectomy (44), total thyroidectomy (8), completion thyroidectomy due to goiter reoccurrence and cancer (2 and 1 patients, respectively). PTH and serum calcium levels were assessed one day prior to surgery, intraoperatively during wound closure, on the first postoperative day and 2 months after surgery. Hypoparathyroidism was defined as parathormone level less than 15 pg/ml. RESULTS Seventeen patients presented ioPTH levels below 15 pg/ml. Twelve of them had low 24PTH levels. Only one patient with ioPTH (but not 24PTH) below 15 pg/ml developed persistent hypoparathyroidism, resulting in low parathormone level 2 months after surgery. Three investigated subjects with ioPTH greater than 15 pg/ml had low 24PTH levels but none of them developed persistent hypoparathyroidism. One patient with ioPTH and 24PTH within reference range presented hypoparathyroidism at the 2-month follow-up, presumably due to postoperative iodotherapy. CONCLUSIONS This study suggests that ioPTH and 24PTH levels are not useful prognostic factors of persistent hypoparathyroidism but may indicate transient parathyroid gland dysfunction.
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8.
Effect of iron repletion and correction of iron deficiency on thyroid function in iron-deficient Iranian adolescent girls.
Eftekhari, MH, Eshraghian, MR, Mozaffari-Khosravi, H, Saadat, N, Shidfar, F
Pakistan journal of biological sciences : PJBS. 2007;(2):255-60
Abstract
The aim of this study was to determine whether iron supplementation in iron-deficient adolescent girls would improve thyroid function. A double-blind clinical trial was performed in a region in southern I.R. Iran. A total of 103 iron deficient participants were chosen. In all, 94 participants successfully completed this study. Participants were randomly assigned to one of two groups and treated with a 300 mg ferrous sulfate 5 times/week (n = 47) and placebo 5 times/week (n = 47) for 12 weeks. Blood samples were collected and assayed for hemoglobin, hematocrit, serum ferritin, iron, total iron binding capacity (TIBC), Thyroid stimulating hormone (TSH), total thyroxine (TT4), total triiodothyronine (TT3), free thyroid hormones (FT4 and FT3), triiodothyronine resin uptake (T3RU), reverse triiodothyronine (rT3), selenium and albumin concentrations. Statistical analysis was performed with parametric and non-parametric methods as appropriate. Data analysis revealed a significant increase in TT4, TT3, T3RU and a significant decrease in rT3 concentration in comparison to initial values in iron treated group (12%, p<0.001; 3.5%, p<0.001; 16%, p<0.05 and 47%, p<0.001, respectively). At 12 week there were significant differences between control and placebo in TT4, TT3, T3RU and rT3 concentrations (9.9 vs 8.4 microg dL(-1), 145.2 vs 130.4 microg dL(-1), 32.5 vs 28.4% and 23 vs 41 microg dL(-1), respectively, all p<0.001). Alterations in FT3 and TSH concentration were not significant, but concentration of FT4 revealed a significant difference between the beginning and the end of the study in iron treated group (10.3 vs 11.4, p<0.001). Iron supplementation improves some indices of thyroid function in iron-deficient adolescent girls.
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9.
Value of (124)I-PET/CT in staging of patients with differentiated thyroid cancer.
Freudenberg, LS, Antoch, G, Jentzen, W, Pink, R, Knust, J, Görges, R, Müller, SP, Bockisch, A, Debatin, JF, Brandau, W
European radiology. 2004;(11):2092-8
Abstract
The aim of this study is to evaluate the clinical significance of (124)I positron emission tomography (PET) using a combined PET/CT tomograph in patients with differentiated thyroid carcinoma and to compare the PET/CT results with (131)I whole-body scintigraphy (WBS), dedicated PET and CT alone. Twelve thyroid cancer patients were referred for diagnostic workup and entered complete clinical evaluation, including histology, cytology, thyroglobulin level, ultrasonography, fluorine-18 fluorodeoxyglucose (FDG)-PET, FDG-PET/CT and CT. Lesion-based evaluation showed a lesion delectability of 56, 87 and 100% for CT, (124)I-PET, and combined (124)I-PET/CT imaging, respectively. Lesion delectability of (131)I-WBS was 83%. We conclude that (124)I-PET/CT imaging is a promising technique to improve treatment planning in thyroid cancer. It is particularly valuable in patients suffering from advanced differentiated thyroid cancer prior to radio-iodine therapy and in patients with suspected recurrence and potential metastatic disease.
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10.
The effects of vitamin A deficiency and vitamin A supplementation on thyroid function in goitrous children.
Zimmermann, MB, Wegmüller, R, Zeder, C, Chaouki, N, Torresani, T
The Journal of clinical endocrinology and metabolism. 2004;(11):5441-7
Abstract
In developing countries, children are at high risk for both the iodine deficiency disorders (IDD) and vitamin A deficiency (VAD). The study aim was to determine the effects of VAD and vitamin A (VA) supplementation on thyroid function in an area of endemic goiter. In a double-blind, randomized, 10-month trial, Moroccan children with IDD and VAD (n = 138) were given iodized salt and either VA (200,000 IU) or placebo at 0 and 5 months. At 0, 5, and 10 months, measurements of VA status and thyroid function were made. At baseline, increasing VAD severity was a predictor of greater thyroid volume and higher concentrations of TSH and thyroglobulin (P < 0.001). In children with VAD, the odds ratio for goiter was 6.51 (95% confidence interval, 2.94, 14.41). VAD severity was also a strong predictor of higher concentrations of total T(4) (P < 0.001); the odds ratio for hypothyroidism in VAD was 0.06 (95% confidence interval, 0.03, 0.14). During the intervention, mean thyroglobulin, median TSH, and the goiter rate significantly decreased in the VA-treated group compared with those in the placebo group (P < 0.01). The findings indicate that VAD in severely IDD-affected children increases TSH stimulation and thyroid size and reduces the risk for hypothyroidism. This effect could be due to decreased VA-mediated suppression of the pituitary TSHbeta gene. In IDD- and VAD-affected children receiving iodized salt, concurrent VA supplementation improves iodine efficacy.