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Missouri Medicine 2022Thyroid storm is a severe manifestation of thyrotoxicosis. Thyroid storm is diagnosed as a combination of thyroid function studies showing low to undetectable thyroid... (Review)
Review
Thyroid storm is a severe manifestation of thyrotoxicosis. Thyroid storm is diagnosed as a combination of thyroid function studies showing low to undetectable thyroid stimulating hormone (TSH) (<0.01mU/L) with elevated free thyroxine (T4) and/or triiodothyronine (T3), positive thyroid receptor antibody (TRab) (if Graves' disease is the underlying etiology), and with clinical signs and symptoms of end organ damage. Treatment involves bridging to a euthyroid state prior to total thyroidectomy or radioactive iodine ablation to limit surgical complications such as excessive bleeding from highly vascular hyperthyroid tissue or exacerbation of thyrotoxicosis. The purpose of this article is a clinical review of the various treatments and methodologies to achieve a euthyroid state in patients with thyroid storm prior to definitive therapy.
Topics: Graves Disease; Humans; Iodine; Iodine Radioisotopes; Thyroid Crisis; Thyroid Neoplasms; Thyrotoxicosis; Thyrotropin; Thyroxine; Triiodothyronine
PubMed: 36118802
DOI: No ID Found -
Scientific Reports Mar 2022Radioactive iodine (I) is used after surgery in the treatment of Differentiated Thyroid Carcinoma (DTC). There is no solid evidence about the potential deleterious...
Radioactive iodine (I) is used after surgery in the treatment of Differentiated Thyroid Carcinoma (DTC). There is no solid evidence about the potential deleterious effect of I on women fertility. The objective of this study is to assess the impact that I may have on fertility in women. All women followed by DTC in our department have been analyzed and women younger than 45 years old at the time of diagnosis and initial treatment were included. There were 40 women exposed to I (study group) and 11 women who were only treated with thyroidectomy (control group). Of the women exposed to I, 40% went through early menopause, while no cases were reported among their controls. Furthermore, 29.2% of women exposed to I had decreased Antimüllerian Hormone (AMH), compared to the only 11% of unexposed women (not significant). Regarding the fertility impairment "perceived" by patients, in the group of women exposed to iodine, 17.9% described being unable to complete their genesic desire whereas, none was registered in the control group. We conclude that radioactive iodine can affect a woman's fertility and shorten her reproductive life, so this is an aspect that should be taken into consideration.
Topics: Female; Fertility; Humans; Iodine; Iodine Radioisotopes; Male; Middle Aged; Thyroid Neoplasms; Thyroidectomy
PubMed: 35260614
DOI: 10.1038/s41598-022-07592-8 -
Endocrine Reviews Jan 2024Radiation is an environmental factor that elevates the risk of developing thyroid cancer. Actual and possible scenarios of exposures to external and internal radiation... (Review)
Review
Radiation is an environmental factor that elevates the risk of developing thyroid cancer. Actual and possible scenarios of exposures to external and internal radiation are multiple and diverse. This article reviews radiation doses to the thyroid and corresponding cancer risks due to planned, existing, and emergency exposure situations, and medical, public, and occupational categories of exposures. Any exposure scenario may deliver a range of doses to the thyroid, and the risk for cancer is addressed along with modifying factors. The consequences of the Chornobyl and Fukushima nuclear power plant accidents are described, summarizing the information on thyroid cancer epidemiology, treatment, and prognosis, clinicopathological characteristics, and genetic alterations. The Chornobyl thyroid cancers have evolved in time: becoming less aggressive and driver shifting from fusions to point mutations. A comparison of thyroid cancers from the 2 areas reveals numerous differences that cumulatively suggest the low probability of the radiogenic nature of thyroid cancers in Fukushima. In view of continuing usage of different sources of radiation in various settings, the possible ways of reducing thyroid cancer risk from exposures are considered. For external exposures, reasonable measures are generally in line with the As Low As Reasonably Achievable principle, while for internal irradiation from radioactive iodine, thyroid blocking with stable iodine may be recommended in addition to other measures in case of anticipated exposures from a nuclear reactor accident. Finally, the perspectives of studies of radiation effects on the thyroid are discussed from the epidemiological, basic science, and clinical points of view.
Topics: Humans; Thyroid Neoplasms; Iodine Radioisotopes; Radioactive Hazard Release; Iodine
PubMed: 37450579
DOI: 10.1210/endrev/bnad022 -
Chemical Society Reviews Apr 2022Nuclear power will continue to provide energy for the foreseeable future, but it can pose significant challenges in terms of the disposal of waste and potential release... (Review)
Review
Nuclear power will continue to provide energy for the foreseeable future, but it can pose significant challenges in terms of the disposal of waste and potential release of untreated radioactive substances. Iodine is a volatile product from uranium fission and is particularly problematic due to its solubility. Different isotopes of iodine present different issues for people and the environment. I has an extremely long half-life of 1.57 × 10 years and poses a long-term environmental risk due to bioaccumulation. In contrast, I has a shorter half-life of 8.02 days and poses a significant risk to human health. There is, therefore, an urgent need to develop secure, efficient and economic stores to capture and sequester ionic and neutral iodine residues. Metal-organic framework (MOF) materials are a new generation of solid sorbents that have wide potential applicability for gas adsorption and substrate binding, and recently there is emerging research on their use for the selective adsorptive removal of iodine. Herein, we review the state-of-the-art performance of MOFs for iodine adsorption and their host-guest chemistry. Various aspects are discussed, including establishing structure-property relationships between the functionality of the MOF host and iodine binding. The techniques and methodologies used for the characterisation of iodine adsorption and of iodine-loaded MOFs are also discussed together with strategies for designing new MOFs that show improved performance for iodine adsorption.
Topics: Adsorption; Humans; Iodine; Ions; Metal-Organic Frameworks
PubMed: 35363235
DOI: 10.1039/d0cs01192d -
Endocrine Pathology Mar 2023The effects of many pharmacological agents on thyroid function are well known. Direct influences on measurements of thyroid function tests are also described. However,... (Review)
Review
The effects of many pharmacological agents on thyroid function are well known. Direct influences on measurements of thyroid function tests are also described. However, certain classes of drugs produce morphological changes in the gland. This review focuses on the significance of the following drug classes for the thyroid pathologist: iodine, antithyroid drugs, psychotropic drugs, antibiotics, cardiotropic drugs, antidiabetic drugs, and immunomodulatory agents. Radioactive iodine initially induces mild histologic changes; however, the long-term effects include marked follicular atrophy, fibrosis, and nuclear atypia-changes that vary depending on the pre-therapy condition of the gland. Some psychotropic drugs have been associated with a spectrum of inflammatory changes throughout the gland. The tetracycline class of antibiotics, namely minocycline, can lead to a grossly black thyroid gland with pigment seen in both colloid and follicular epithelial cells while variably present within thyroid nodules. The surgical pathologist most commonly sees an amiodarone-affected gland removed for hyperthyroidism, and the histologic findings again depend on the pre-therapy condition of the gland. While GLP-1 receptor agonists carry an FDA black box warning for patients with a personal or family history of multiple endocrine neoplasia or medullary thyroid carcinoma, the C cell hyperplasia originally noted in rats has not borne out in human studies. Finally, thyroiditis and hypothyroidism are well known complications of checkpoint inhibitor therapy, and rare cases of severe thyroiditis requiring urgent thyroidectomy have been reported with unique histologic findings. In this review, we describe the histologic findings for these drugs and more, in many cases including their functional consequences.
Topics: Humans; Animals; Rats; Iodine Radioisotopes; Pathologists; Thyroid Neoplasms; Thyroiditis; Anti-Bacterial Agents; Iodine
PubMed: 36723855
DOI: 10.1007/s12022-023-09749-1 -
Water Research Aug 2022Environmental damage from serious nuclear accidents should be urgently restored, which needs the removal of radioactive species. Radioactive iodine isotopes are...
Environmental damage from serious nuclear accidents should be urgently restored, which needs the removal of radioactive species. Radioactive iodine isotopes are particularly problematic for human health because they are released in large amounts and retain radioactivity for a substantial time. Herein, we prepare platinum-coated iron nanoparticles (Fe@Pt) as a highly selective and reusable adsorbent for iodine species, i.e., iodide (I), iodine (I), and methyl iodide (CHI). Fe@Pt selectively separates iodine species from seawater and groundwater with a removal efficiency ≥ 99.8%. The maximum adsorption capacity for the iodine atom of all three iodine species was determined to be 25 mg/g. The magnetic properties of Fe@Pt allow for the facile recovery and reuse of Fe@Pt, which remains stable with high efficiency (97.5%) over 100 uses without structural and functional degradation in liquid media. Practical application to the removal of radioactive I and feasibility for scale-up using a 20 L system demonstrate that Fe@Pt can function as a reusable adsorbent for the selective removal of iodine species. This systematic procedure is a standard protocol for designing highly active adsorbents for the clean separation and removal of various chemical species dissolved in wastewater.
Topics: Adsorption; Humans; Iodides; Iodine; Iodine Radioisotopes; Thyroid Neoplasms; Water; Water Pollutants, Chemical
PubMed: 35870393
DOI: 10.1016/j.watres.2022.118864 -
Journal of Applied Clinical Medical... Jan 2021March 2021 will mark the eightieth anniversary of targeted radionuclide therapy, recognizing the first use of radioactive iodine to treat thyroid disease by Dr. Saul...
March 2021 will mark the eightieth anniversary of targeted radionuclide therapy, recognizing the first use of radioactive iodine to treat thyroid disease by Dr. Saul Hertz on March 31, 1941. The breakthrough of Dr. Hertz and collaborator physicist Arthur Roberts was made possible by rapid developments in the fields of physics and medicine in the early twentieth century. Although diseases of the thyroid gland had been described for centuries, the role of iodine in thyroid physiology had been elucidated only in the prior few decades. After the discovery of radioactivity by Henri Becquerel in 1897, rapid advancements in the field, including artificial production of radioactive isotopes, were made in the subsequent decades. Finally, the diagnostic and therapeutic use of radioactive iodine was based on the tracer principal that was developed by George de Hevesy. In the context of these advancements, Hertz was able to conceive the potential of using of radioactive iodine to treat thyroid diseases. Working with Dr. Roberts, he obtained the experimental data and implemented it in the clinical setting. Radioiodine therapy continues to be a mainstay of therapy for hyperthyroidism and thyroid cancer. However, Hertz struggled to gain recognition for his accomplishments and to continue his work and, with his early death in 1950, his contributions have often been overlooked until recently. The work of Hertz and others provided a foundation for the introduction of other radionuclide therapies and for the development of the concept of theranostics.
Topics: Humans; Iodine; Iodine Radioisotopes; Precision Medicine; Thyroid Neoplasms
PubMed: 33533204
DOI: 10.1002/acm2.13175 -
Proceedings of the Royal Society of... Apr 1953
Topics: Disease; Iodine; Iodine Radioisotopes; Radioisotopes; Thyroid Diseases; Thyroid Gland
PubMed: 13055872
DOI: No ID Found -
Journal of Cancer Research and... 2016Papillary and follicular cancers of thyroid are the most common varieties of differentiated thyroid cancers exhibiting excellent long-term prognosis when carefully... (Review)
Review
Papillary and follicular cancers of thyroid are the most common varieties of differentiated thyroid cancers exhibiting excellent long-term prognosis when carefully managed. Being a slow-growing malignancy, guidelines exist on the staging, preoperative risk stratification, and management of these cancers to increase the overall survival of these patients. Radioactive iodine has a central role in differentiated thyroid malignancies. It has the same physical properties as stable iodine, thus both normal and malignant thyrocytes cannot differentiate radioactive from stable iodine. Differentiated thyroid carcinoma (DTC) cells concentrate cytocidal amounts of Iodine -131 (131 I) by trapping (the function of the sodium iodine symporter, or NIS) and organifying the iodide ion to produce levothyroxine and triiodothyronine. We shall discuss the role of radioiodine in the management and followup of DTC patients.
Topics: Ablation Techniques; Algorithms; Disease Management; Humans; Iodine Radioisotopes; Neoplasm Grading; Patient Selection; Radiometry; Radiotherapy Dosage; Radiotherapy, Adjuvant; Thyroid Neoplasms
PubMed: 28054519
DOI: 10.4103/0973-1482.163677 -
The Quarterly Journal of Nuclear... Sep 2021It is well known nowadays that radioactivity can destroy the living cells it interacts with. It is therefore unsurprising that radioactive sources, such as iodine-125,... (Review)
Review
It is well known nowadays that radioactivity can destroy the living cells it interacts with. It is therefore unsurprising that radioactive sources, such as iodine-125, were historically developed for treatment purposes within radiation oncology with the goal of damaging malignant cells. However, since then, new techniques have been invented that make creative use of the same radioactivity properties of these sources for medical applications. Here, we review two distinct kinds of therapeutic uses of radioactive sources with applications to prostate, cervical, and breast cancer: brachytherapy and radioactive seed localization. In brachytherapy (BT), the radioactive sources are used for internal radiation treatment. Current approaches make use of real-time image guidance, for instance by means of magnetic resonance imaging, ultrasound, computed tomography, and sometimes positron emission tomography, depending on clinical availability and cancer type. Such image-guided BT for prostate and cervical cancer presents a promising alternative and/or addition to external beam radiation treatments or surgical resections. Radioactive sources can also be used for radio-guided tumor localization during surgery, for which the example of iodine-125 seed use in breast cancer is given. Radioactive seed localization (RSL) is increasingly popular as an alternative tumor localization technique during breast cancer surgery. Advantages of applying RSL include added flexibility in the clinical scheduling logistics, an increase in tumor localization accuracy, and higher patient satisfaction; safety measures do however have to be employed. We exemply the implementation of RSL in a clinic through our experiences at the Netherlands Cancer Institute.
Topics: Brachytherapy; Breast Neoplasms; Humans; Male; Radioactivity
PubMed: 34105339
DOI: 10.23736/S1824-4785.21.03370-7