Search Results (5)

Plaque radiotherapy is an effective treatment modality for medium-sized ocular tumors such as uveal melanoma. The authors review the available literature and concisely summarize the current state of the art of ophthalmic plaque brachytherapy. The choice of radioisotope, which includes Ruthenium-106 and Iodine-125, depends on the intended treatment duration, tumor characteristics, and side effect profiles. Ophthalmic plaques may be customized to allow for the delivery of a precise radiation dose by adjusting seed placement and plaque shape to minimize collateral tissue radiation. High dose rate (HDR) brachytherapy, using beta (e.g., Yttrium-90) and photon-emitting sources (e.g., Ytterbium-169, Selenium-75), allows for rapid radiation dose delivery, which typically lasts minutes, compared to multiple days with low-dose plaque brachytherapy. The efficacy of Ruthenium-106 brachytherapy for uveal melanoma varies widely, with reported local control rates between 59.0% and 98.0%. Factors influencing outcomes include tumor size, thickness, anatomical location, and radiation dose at the tumor apex, with larger and thicker tumors potentially exhibiting poorer response and a higher rate of complications. Plaque brachytherapy is effective for selected tumors, particularly uveal melanoma, providing comparable survival rates to enucleation for medium-sized tumors. The complications of plaque brachytherapy are well described, and many of these are treatable. Full article

Background: Severe maternal iodine deficiency has profound consequences for the developing brain; however, the impact of mild to moderate deficiency is less clear, and findings from observational studies have been mixed. Aim: The purpose of this study is to assess the relationship between maternal iodine status in early pregnancy and infant neurological development in an Irish maternal–infant cohort. Methods: Maternal–infant dyads of the Improved Pregnancy Outcomes by Early Detection (IMPROvED) and the Cork Nutrition and Development (COMBINE) cohorts (n 456) were followed during pregnancy and from birth to 2 years of age. Participants completed detailed a clinical and questionnaire-based assessments (including Bayley’s Scale of Infant Development (BSID-III) at 24 months; n 295). Maternal urinary iodine concentration (UIC) was quantified at 15 weeks of gestation by the Sandell–Kolthoff (S-K) method, and urinary creatinine (Cr) was quantified by the Jaffe rate method using the RX Monaco Clinical Chemistry Analyser (Randox Laboratories Ltd.). Statistical analysis was performed using IBM SPSS Version 27 (IBM Corp., Armonk, NY, USA). Results: The median (IQR) maternal age at delivery was 32 (5) years, and the median (IQR) BMI at 15 weeks of gestation was 25.1 (5.0) kg/m². Three-quarters completed third-level education, 95% were in a relationship and 7% were smokers. Median (IQR) UIC was 118 (132) µg/L, and 65% had UIC < 150 µg/L. At 24 months, median (IQR) cognitive, language and motor composite scores were 105 (15), 103 (20) and 103 (14), respectively. Cognitive, language and motor developmental delay was indicated in 6.0, 7.8 and 0.4% of children, respectively. Though a slightly higher prevalence of developmental language delay was observed among infants of mothers with UI:Cr < 150 µg/g for language (11 versus 6%) and a combined cognitive/language outcome (10 versus 4%), when adjusted for education, marital status, gestational age and birthweight, UI:Cr was not associated with language delay (aOR (95% CI): 1.7 (0.6, 4.7)). Among non-users of iodine supplements (29% of sample; median (IQR) UIC: 84 (96) µg/L; 75% < 150 µg/L), for every 10 µg/L increase in UIC, we observed a 23% and 19% reduction in odds of cognitive and language delay, respectively (aOR (95% CI): 0.77 (0.71, 0.97), p = 0.029; 0.81 (0.66, 0.99), p = 0.035). Our findings highlight the importance of sufficient iodine status in early pregnancy. Full article

This meta-analysis investigated whether thyroidectomy or radioactive iodine treatment (RAIT) in patients with differentiated thyroid cancer (DTC) was associated with an increase in adverse pregnancy outcomes, such as miscarriage, preterm delivery, and congenital malformations. A total of 22 articles (5 case-control and 17 case series studies) from 1262 studies identified through a literature search in the PubMed and EMBASE databases from inception up to 13 September 2021 were included. In patients with DTC who underwent thyroidectomy, the event rates for miscarriage, preterm labor, and congenital anomalies were 0.07 (95% confidence interval [CI], 0.05–0.11; 17 studies), 0.07 (95% CI, 0.05–0.09; 14 studies), and 0.03 (95% CI, 0.02–0.06; 17 studies), respectively. These results are similar to those previously reported in the general population. The risk of miscarriage or abortion was increased in patients with DTC when compared with controls without DTC (odds ratio [OR], 1.80; 95% CI, 1.28–2.53; I² = 33%; 3 studies), while the OR values for preterm labor and the presence of congenital anomalies were 1.22 (95% CI, 0.90–1.66; I² = 62%; five studies) and 0.73 (95% CI, 0.39–1.38; I² = 0%; two studies) respectively, which showed no statistical significance. A subgroup analysis of patients with DTC according to RAIT revealed that the risk of miscarriage, preterm labor, or congenital anomalies was not increased in the RAIT group when compared with patients without RAIT. The results of this meta-analysis suggest that thyroid cancer treatment, including RAIT, is not associated with an increased risk of adverse pregnancy outcomes, including miscarriage, preterm labor, and congenital anomalies. Full article

Objectives: To evaluate multiphase low kV computed tomography (CT) imaging of the abdomen with reduced contrast media (CM) dose using different injection protocols. Methods: Two injection protocols were evaluated for use with low kV (80 kV) multiphase abdominal imaging in comparison to the standard procedure acquired at 120 kV (500 mgI/kg; 5 mL/s). This evaluation was conducted in a highly standardized animal study (5 Goettingen minipigs). The low kV protocols consisted of (a) a single-flow (SF) injection with 40% reduced CM dose and injection rate (300 mgI/kg; 3 mL/s) and (b) a DualFlow (DF) injection protocol consisting of 60%/40% contrast to saline ratio administered at 5 mL/s. Dynamic CT was first performed within representative liver regions to determine optimal contrast phases, followed by evaluation of the three protocols in multiphase abdominal CT imaging. The evaluation criteria included contrast enhancement (CE) of abdominal organs and vasculature. Results: The 80 kV DF injection protocol showed similar CE of the abdominal parenchymatous organs and vessels to the 120 kV reference and the 80 kV SF protocol. Hepatic parenchyma showed comparable CT values for all contrast phases. In particular, in the portal venous parenchymal phase, the 80 kV DF protocol demonstrated higher hepatic parenchymal enhancement; however, results were statistically non-significant. Similarly, CE of the kidney, pancreas, and abdominal arterial/venous vessels showed no significant differences between injection protocols. Conclusions: Adapted SF and DF injection protocols with reduced IDR/iodine load offer the potential to calibrate optimal CM doses to the tube voltage in abdominal multiphase low kV CT imaging. The data suggest that the DF approach allows the use of predefined injection protocols and adaption of the contrast to saline ratio to an individualized kV setting and yields the potential for patient-individualized CM adaption. Full article

The use of nanomaterials for improving drug delivery methods has been shown to be advantageous technically and viable economically. This study employed the use of halloysite nanotubes (HNTs) as nanocontainers, as well as enhancers of structural integrity in electrospun poly-e-caprolactone (PCL) scaffolds. HNTs were loaded with amoxicillin, Brilliant Green, chlorhexidine, doxycycline, gentamicin sulfate, iodine, and potassium calvulanate and release profiles assessed. Selected doped halloysite nanotubes (containing either Brilliant Green, amoxicillin and potassium calvulanate) were then mixed with poly-e-caprolactone (PLC) using the electrospinning method and woven into random and oriented-fibered nanocomposite mats. The rate of drug release from HNTs, HNTs/PCL nanocomposites, and their effect on inhibiting bacterial growth was investigated. Release profiles from nanocomposite mats showed a pattern of sustained release for all bacterial agents. Nanocomposites were able to inhibit bacterial growth for up to one-month with only a slight decrease in bacterial growth inhibition. We propose that halloysite doped nanotubes have the potential for use in a variety of medical applications including sutures and surgical dressings, without compromising material properties. Full article