A comparison of thyroidal protection by iodine and perchlorate against radioiodine exposure in Caucasians and Japanese

xlomafota13 shared this article with you from Inoreader A comparison of thyroidal protection by iodine and perchlorate against radioiodine exposure in Caucasians and Japanese Via radioactive iodine Arch Toxicol. 2021 May 18. doi: 10.1007/s00204-021-03065-5. Online ahead of print. ABSTRACT Radioactive iodine released in nuclear accidents may accumulate in the thyroid and by irradiation enhances the risk of cancer. Radioiodine uptake into the gland can be inhibited by large doses of stable iodine or perchlorate. Nutritional iodine daily intake may impact thyroid physiology, so that radiological doses absorbed by the thyroid as well as thyroid blocking efficacy may differ in Jap anese with a very rich iodine diet compared to Caucasians. Based on established biokinetic-dosimetric models for the thyroid, we derived the parameters for Caucasians and Japanese to quantitatively compare the effects of radioiodine exposure and the protective efficacy of thyroid blocking by stable iodine at the officially recommended dosages (100 mg in Germany, 76 mg in Japan) or perchlorate. The maximum transport capacity for iodine uptake into the thyroid is lower in Japanese compared to Caucasians. For the same radioiodine exposure pattern, the radiological equivalent thyroid dose is substantially lower in Japanese in the absence of thyroid blocking treatments. In the case of acute radioiodine exposure, stable iodine is less potent in Japanese (ED50 = 41.6 mg) than in Caucasians (ED50 = 2.7 mg) and confers less thyroid protection at the recommended dosages because of a delayed responsiveness to iodine saturation of the gland (Wolff-Chaikoff effect). Perchlo rate (ED50 = 10 mg in Caucasians) at a dose of 1000 mg has roughly the same thyroid blocking effect as 100 mg iodine in Caucasians, whereas it confers a much better protection than 76 mg iodine in Japanese. For prolonged exposures, a single dose of iodine offer substantially lower protection than after acute radioiodine exposure in both groups. Repetitive daily iodine administrations improve efficacy without reaching levels after acute radioiodine exposure and achieve only slightly better protection in Japanese than in Caucasians. However, in the case of continuous radioiodine exposure, daily doses of 1000 mg perchlorate achieve a high protective efficacy in Caucasians as well as Japanese (> 0.98). In Caucasians, iodine (100 mg) and perchlorate (1000 mg) at the recommended dosages seem alternatives in case of acute radioiodine exposure, whereas perchlorate has a higher protective efficacy in the case of longer lasting radioiodine exposures. In Japanese, considering pro tective efficacy, preference should be given to perchlorate in acute as well as prolonged radioiodine exposure scenarios. PMID:34003340 | DOI:10.1007/s00204-021-03065-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spontaneous acute bleeding within subdural effusion from dural metastasis of gastric cancer: A case report

xlomafota13 shared this article with you from Inoreader Spontaneous acute bleeding within subdural effusion from dural metastasis of gastric cancer: A case report Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 May 14:S1130-1473(21)00047-6. doi: 10.1016/j.neucir.2021.04.001. Online ahead of print. ABSTRACT Dural metastases are uncommon findings and at diagnosis normally appear in disseminated stages of malignant tumors. Usually clinically silent, these could become symptomatic due to mass effect or after developing subdural collections. We present the case of a young woman recently operated from gastric cancer who presented consciousness deterioration and hemiparesis caused by subdural collection. During examination, the patient drastically worsens his neurological status due to an acute subdural bleeding within the subdural collection, which after pathological analysis was diagnosed of dural metastasis of gastric cancer. In malignancies associated with subdural collections it is important to suspect the coexistence of dural metastases and performing a contrast enhanced CT scan or Magnetic Resonance Imaging (MRI) may help in the diagnosis. If surgery is indicated, it is mandatory to evacuate the tumor and involved dura which causes the accumulation of fluid and to coagulate the external tumor membrane to avoid re-bleeding. PMID:34001435 | DOI:10.1016/j.neucir.2021.04.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radiotherapy for prevention or management of gynecomastia recurrence: Future role for general gynecomastia patients in plastic surgery given current role in management of high-risk prostate cancer patients on anti-androgenic therapy

xlomafota13 shared this article with you from Inoreader Radiotherapy for prevention or management of gynecomastia recurrence: Future role for general gynecomastia patients in plastic surgery given current role in management of high-risk prostate cancer patients on anti-androgenic therapy Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 20:S1748-6815(21)00202-3. doi: 10.1016/j.bjps.2021.03.098. Online ahead of print. ABSTRACT PURPOSE: Several technologies and innovative approaches continue to emerge for the optimal management of gynecomastia by plastic surgeons; the present study investigates the role of radiation therapy in this context. METHODS: A systematic review was performed to evaluate the utility of radiotherapy for the prevention and treatment of gynecomastia incidence or recurrence by plastic surgeons. RESULTS: Fifteen articles met the inclusion criteria for review. The mean incidence of gynecomastia was 70% in the high-risk population examined representing prostate cancer patients on estrogen or anti-androgen therapy. Radiotherapy was shown to significantly reduce the incidence to a median of 23%, with all six randomized control studies assessed demonstrating a statistically significant decrease in inciden ce following radiotherapy prophylaxis. Doses examined ranged from 8 to 16 Gy, delivered between 1 and 11 fractions. Complications following radiotherapy were minor and self-limiting in all cases, restricted to minor skin reactions, and associated with larger radiotherapy doses delivered in fewer fractions. The median complication rate was 12.4% with no major complications, such as neoplastic, pulmonary, or adverse cardiac outcomes. While the efficacy of radiation therapy as a treatment modality for gynecomastia was also established, it was shown to be less effective than other available options. CONCLUSIONS: Low-dose radiotherapy to the male breast might be a safe and effective strategy to prevent gynecomastia incidence or recurrence in high-risk patients; further studies are indicated within the common gynecomastia population managed by plastic surgeons to assess the clinical and economical utility of this intervention before a recommendation for its ubiquitous adoption in pl astic surgery can be made to continue improving outcomes for high-risk gynecomastia patients. PMID:34001449 | DOI:10.1016/j.bjps.2021.03.098 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Metastatic tumour of the hand - Three new cases and a literature review

xlomafota13 shared this article with you from Inoreader Metastatic tumour of the hand - Three new cases and a literature review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 19:S1748-6815(21)00189-3. doi: 10.1016/j.bjps.2021.03.084. Online ahead of print. ABSTRACT Metastatic tumours of the hand are rare, and therefore, is the subject of only a few publications in the literature. We report on three new cases along with a retrospective and descriptive study with file and literature analysis dating from 1900 to 2017, which reported on 337 studies. To perform the statistical analysis, ordinary lease square regression was used to group the metastases into distal phalanx, proximal/middle phalanx, thumb, hand and carpus. We found 564 metastases at the hand for a total of 482 patients. Of the reported cases, 60% were male. The average age was 59 years. The main primary cancers were lung cancer (40%), followed by gastrointestinal (19%), genito-urinary (13%), gynaecological (11%) and ear, nose and throat (6%) cancers. The mean survival time was 7.2 months. Fifty-nine per cent was bone metastasis, 18% tissue metastasis and 3% cutaneous metastasis. In 20% of cases, the type of metastasis was not mentioned. Of all the tissue metastases, 47 (54%) were subungual and in that group, the thumb was the finger most commonly affected. Overall, metastases most commonly appeared in the distal phalanx, which can be explained by a greater vascularisation as well as microtraumatisms. Survival was independent of the epidemiological criteria and of the location and type of metastasis. Patients with primary urological cancer lived on average 3 months longer than patients with other types of primary cancers. PMID:34001450 | DOI:10.1016/j.bjps.2021.03.084 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.