Activated carbon cloth versus silver-based dressings in a population with diabetic foot ulcer: a randomised controlled trial.

OBJECTIVE: Activated carbon cloth (ACC), known as Zorflex dressing, has emerged as an innovative approach in managing bacterial infection in diabetic foot ulcer (DFU) treatment. This pilot study was undertaken to determine the efficacy of Zorflex ACC dressing (Chemviron Carbon Cloth Division, UK) compared to standard silver-based dressing on DFUs. METHOD: An open label, comparative, randomised controlled trial enrolling patients who attended the diabetic foot clinic was conducted between August 2022 and August 2023. The primary endpoint was a difference of 20% in wound area reduction with the ACC dressing compared to silver-based dressing within eight weeks. The secondary endpoints were proportion of complete healing, time to healing and adverse events. RESULTS: The cohort comprised 40 patients. The mean wound reduction percentage at 8 weeks for patients in the ACC arm was 85.40±16.00% compared with 65.08±16.36% in the silver-based dressing arm. Complete healing was observed in six of 20 patients in the ACC arm compared to two of 20 in the silver-based dressing arm. CONCLUSION: These data suggest that the ACC dressing promotes better ulcer healing in DFU patients than the silver-based dressing.

Prophylactic Oral Application of Activated Charcoal Mitigates Acute Campylobacteriosis in Human Gut Microbiota-Associated IL-10-/- Mice.

The incidence of human Campylobacter jejuni infections is increasing worldwide. It is highly desirable to prevent campylobacteriosis in individuals at risk for severe disease with antibiotics-independent non-toxic compounds. Activated charcoal (AC) has long been used as an anti-diarrheal remedy. Here, we tested the disease-mitigating effects of oral AC versus placebo in human gut microbiota-associated (hma) IL-10-/- mice starting a week prior to C. jejuni infection. On day 6 post-infection, the gastrointestinal C. jejuni loads were comparable in both infected cohorts, whereas campylobacteriosis symptoms such as wasting and bloody diarrhea were mitigated upon AC prophylaxis. Furthermore, AC application resulted in less pronounced C. jejuni-induced colonic epithelial cell apoptosis and in dampened innate and adaptive immune cell responses in the colon that were accompanied by basal concentrations of pro-inflammatory mediators including IL-6, TNF-α, IFN-γ, and nitric oxide measured in colonic explants from AC treated mice on day 6 post-infection. Furthermore, C. jejuni infection resulted in distinct fecal microbiota shift towards higher enterobacterial numbers and lower loads of obligate anaerobic species in hma mice that were AC-independent. In conclusion, our pre-clinical placebo-controlled intervention study provides evidence that prophylactic oral AC application mitigates acute murine campylobacteriosis.

Sensitivity of dose-estimations for acute acetaminophen overdose in predicting hepatotoxicity risk using the Rumack-Matthew Nomogram.

Timely assessment of acetaminophen concentration in overdose situations is not always available in resource-poor settings. The 150 mg/kg dose-estimate for acetaminophen is widely considered as criterion for acetaminophen overdose. Its sensitivity and specificity when compared to the 150 mg/L treatment line on the Rumack-Matthew Nomogram (150-treatment line) has rarely been evaluated. This is a retrospective chart review of acute acetaminophen overdose patients. We evaluated the sensitivity and specificity of the 150, 200 mg/kg and 8- and 10-g dose-estimates by plotting the serum acetaminophen levels and using 150-treatment line on the Nomogram as the treatment cut-off. A comparison of medical care costs was performed. We enrolled 784 cases for analysis. Median (IQR) age was 23 (20-28) years (81.9% female). There were 545 cases (69.5%) where the estimated ingested acetaminophen dose were ≥150 mg/kg and 406 cases (51.8%) with concentrations ≥150-treatment line. Hepatotoxicity and acute liver injury (ALI) occurred in 7.3% and 23.9%, respectively. The sensitivity and specificity of 150 mg/kg dose-estimate for the 150-treatment line were 92.6% (95% CI 89.6, 94.8) and 55.3% (95% CI 50.3, 60.2). Among patients with dose-estimate below150 mg/kg, none developed hepatotoxicity and 17 (7.1%) develop ALI. The administration of activated charcoal significantly decreased the risk of being above the 150-treatment line by half. In resource-poor setings, the use of 150 mg/kg dose-estimate as a stand-alone criteria for initiation of N-acetylcysteine therapy is satisfactory, especially when combined with decontamination with activated charcoal and follow up of aminotransferase at 24 h.

Alginate-coated activated charcoal enhances fecal excretion of 2,3,7,8-tetrachlorodibenzo-p-dioxin in mice, with fewer side effects than uncoated one.

Activated charcoal (AC) is a potential candidate antidote against dioxins. However, it is difficult to take AC as a supplement on a daily basis, because its long-term ingestion causes side effects such as constipation and deficiency of fat-soluble essential nutrients and hypocholesterolemia. Alginate-coated AC, termed Health Carbon (HC), was developed to decrease the side effects of AC, but its pharmacological effects, including side effects, remains unclear. Here, we show that HC enhanced fecal excretion of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and decreased some side effects of unmodified AC, such as hypocholesterolemia, in male mice. Basal diet mixed with HC or unmodified AC at various concentrations was fed to mice for 16 days following a single intraperitoneal administration of [3H]TCDD. Both HC and unmodified AC at 3% or more significantly increased fecal excretion of [3H]TCDD in comparison with the control basal diet. Consistent with this, [3H]TCDD radioactivity in the liver-a major TCDD storage organ-was markedly decreased by HC at concentrations of 3% and 10%. In an examination of potential side effects, unmodified AC at 10% or more caused significant body weight reduction and at 20% caused significant hypocholesterolemia. In contrast, HC caused weight gain reduction only at a concentration of 20%, and there was no evidence of hypocholesterolemia at any dietary HC concentration. HC not only retains the ability of AC to enhance fecal excretion of TCDD but also reduces some of the side effects of AC.

Impaired Performance of Broiler Chickens Fed Diets Naturally Contaminated with Moderate Levels of Deoxynivalenol.

Mycotoxin exposure is common in the poultry industry. Deoxynivalenol (DON) is usually detected at levels below the maximum threshold (5000 ppb), but depending on diet and age, broiler performance can be affected. We evaluated the effects of 900 ppb and 2300 ppb DON on the performance, intestinal morphometry, and lesion scores of broiler chickens. One-day-old male Ross broilers (n = 736) were divided into 4 treatments with 8 replicates each, and a pen containing 23 birds was the experimental unit. The animals were fed diets naturally contaminated with two levels of DON: 900 (Low DON-LD) or 2300 (Moderate DON-MD) ppb, with or without activated charcoal, over 28 days. After this, all birds were fed a marginally DON-contaminated diet without charcoal. During the first 28 days, body weight gain (BWG) and feed conversion ratio (FCR) were significantly impaired when broilers were fed a MD diet without activated charcoal. Even after feeding a marginally contaminated diet from D28-35, birds previously fed the MD diet presented a significantly lower performance. The villus height:crypt depth (VH:CD) ratio was significantly higher in the ileum from 14-day-old broilers fed the MD when compared with the LD diet. At D28, the MD diet caused decreased villus height (VH) and increased crypt depth (CD), affecting VH:CD ratio in both intestinal segments, with higher levels in the jejunum from 28-day-old broilers fed a non-supplemented LD diet. Broiler production was negatively affected by DON, even at moderate levels (2300 ppb).

The effect of activated charcoal on drug exposure following intravenous administration: A meta-analysis.

Activated charcoal both reduces primary drug absorption and enhances drug elimination. However, the two mechanisms of action overlap and are indistinguishable from each other. In order to estimate the extend of enhanced elimination, we summarized the effect of activated charcoal on intravenously administered drugs, where reduced drug exposure can be attributed to enhanced elimination. We performed a meta-analysis of randomized controlled studies evaluating the effect of orally administered activated charcoal on the systemic exposure of intravenously administered drugs. We searched the bibliographic databases PubMed, Embase and Cochrane. Meta-regression analyses of selected physiochemical drug properties on the effect sizes of activated charcoal were performed. All but one of 21 included studies used multiple-dose activated charcoal (MDAC). MDAC reduced the median half-life of the intravenously administered study drugs by 45.7% (interquartile range: 15.3%-51.3%) and area under the concentration time curve by 47.0% (interquartile range: 36.4%-50.2%). MDAC significantly improved drug elimination across nine different intravenously administered drugs, but we were unable to identify factors allowing extrapolation to other drugs. The results offer a possible and plausible rationale for the previously observed effects of single-dose activated charcoal beyond the timeframe where ingested drug is present in the gastro-intestinal tract.

Effects of bamboo charcoal powder, bamboo vinegar, and their combination in laying hens on performance, egg quality, relative organ weights, and intestinal bacterial populations.

This experiment examines the effects of bamboo charcoal (BC) powder, bamboo vinegar (BV), and their combination (BCV) in the diet of laying hens on performance, egg quality, relative organ weights, and intestinal bacterial populations. A total of 320 laying hens (36 weeks of age) were divided into 4 treatment groups, with 10 replicates per treatment and 8 hens per replicate. They were fed on a control diet, the control diet supplemented with 0.8% BC, the control diet supplemented with 0.4% BV, or the control diet supplemented with a combination of BC (0.8%) and BV (0.4%) from 36 to 51 weeks of age. Egg production increased in the hens fed the BV and BCV diets during 48 to 51 weeks of age (P < 0.05). Damaged egg rate decreased in the hens fed the BV and BCV diets for the whole experiment (P < 0.05). Shell thickness was highest in the BCV-fed group at week 43, and shell strength was higher in the BV-fed group at week 51 (P < 0.05). Supplementation of BC or BCV in the diet resulted in a decreased abdominal fat pad (P < 0.05). In the ileal content, the population of Salmonella spp. decreased in the BV and BCV groups and the population of Lactobacillus spp. increased in the BV group (P < 0.05). The present results indicate that feeding BV or BCV alleviates damaged egg rate and decreases intestinal pathogenic bacteria, while feeding BC benefits by reducing abdominal fat. These results suggest that the effect of BCV seems to be induced by the synergistic effect of BC and BV, and that the BCV contributes to the effective use of bamboo on the laying hen's production.

A Colon-Targeted Adsorbent (DAV132) Does Not Affect the Pharmacokinetics of Warfarin or Clonazepam in Healthy Subjects.

DAV132 is a novel colon-targeted adsorbent that prevents the deleterious impact of antibiotics on gut microbiota without modifying their systemic availability. A randomized, Latin-square crossover, open-label trial with 2 substudies in 18 and 24 healthy volunteers evaluated the pharmacokinetic (PK) bioequivalence of warfarin, a drug with a narrow therapeutic index (NTI), and clonazepam, both widely used for the treatment of chronic conditions, with or without coadministration of DAV132 7.5 g. PK parameters observed with single doses of 5 mg warfarin and 1 mg clonazepam when administered alone did not differ with the PK parameters when administered concomitantly with or 1 hour before DAV132. Geometric mean ratios (GMRs) for S-warfarin, R-warfarin, and clonazepam Cmax were 102.0, 102.8, and 91.9, respectively, after concomitant administration and 106.5, 107.5, and 95.0, respectively, when administered 1 hour before DAV132. After concomitant administration, GMRs for S-warfarin, R-warfarin, and clonazepam AUClast were 100.5, 100.2, and 94.9, respectively, and 101.9, 101.8, and 101.3, respectively, when administered 1 hour before DAV132. All GMR 90% confidence intervals fell within the prespecified 80% to 125% limit for bioequivalence, indicating a lack of drug-drug interaction. In conclusion, DAV132 did not affect the systemic exposure of 2 NTI drugs absorbed in the proximal intestine.

Rice Straw Biochar Application and its Impact on Yield of Some Faba Bean Varieties in Sandy Soil.

<b>Background and Objective:</b> Biological fertilization in the development of agriculture became one new strategy in the increased production of field crops to decrease the costs of production input and environmental pollution. This study focused on the influence of biochar fertilization on the productivity of faba bean varieties under sandy soils. <b>Materials and Methods:</b> Appreciation of the yield and its components, in addition to measurement of grain protein content as well as carbohydrates (%) of faba bean. <b>Results:</b> The data obtained indicated that the biochar amendment affects plant production at different rates, where the best yield obtained is 90 kg fed¹. The grain yield increase is significant for the variety's types where, Mariout-2, followed by Nubaria-3 followed by Giza-716 for the addition of 90 kg fed¹ of biochar as referenced by the non-conditioning treatment. Likewise, the protein content was highest in the Mariout-2 variety, followed by Nubaria-3 variety and Giza-716 variety for the addition. This improvement may be regarded to the impact of biochar on the physic-chemical characteristics for the soils, in addition to the biological characteristics. Furthermore, the biochar itself add nutrient to the soil after decomposition. The best improvement happens by the long-term cropping for a long period could be reached up to years. <b>Conclusion:</b> The conclusion that plant growth was better at a high rate (90 kg fed¹) but the economy of this rate may be questioned, under the condition of the study. However, the validation for different soils may vary with different rates, which needs more research. Also, it is recommended to use Mariout-2 cultivars for their high production under these conditions.

Gut and intestinal biometrics of the giant trevally, Caranx ignobilis, fed an experimental diet with difference sources of activated charcoal.

Background: The giant trevally, Caranx ignobilis, is a commercially important marine fish in Indonesia. This species was initially cultured in Aceh Province. Previous reports showed that charcoal has a positive effect on survival and feed utilization of the giant trevally. However, the effects of adding charcoal to the diet on gut and intestine biometrics has, to our knowledge, never been described. Methods: Four activated charcoal sources were tested in this study using a completely randomized experimental design; coconut shell charcoal, mangrove wood charcoal, rice husk charcoal, and kernel palm shell charcoal. All treatments were performed with four replications. Juvenile giant trevally (average body weight, 16.52 ± 3.12 g; and average total length, 10.26 ± 0.64 cm) were stocked into the experimental tank at a density of 15 fish per tank. The fish were fed an experimental diet twice daily at 7 AM and 5 PM ad satiation for 42 days. Results: Analysis of variance showed that adding charcoal to the diet had significant effects on the length and width of the foveola gastrica and villous intestine (P < 0.05). The greatest length and width of the foveola gastrica was recorded in fish fed an experimental diet of rice husk charcoal with average values of 311.811 ± 9.869 µm and 241.786 ± 10.394 µm, respectively. The greatest length of intestinal villous was found in fish fed the mangrove wood charcoal diet, with a value of 135.012 ± 5.147 µm, but this length was not significantly different to that in fish fed rice charcoal and kernel palm shell charcoal. However, the greatest width of intestinal villous was recorded in fish fed the control diet (without charcoal; P < 0.05). Conclusion: The optimal sizes of the foveola gastrica and villous intestine were found in fish fed an experimental diet with rice husk charcoal.

Effects of biochar-based controlled release nitrogen fertilizer on nitrogen-use efficiency of oilseed rape (Brassica napus L.).

Biochar-based controlled release nitrogen fertilizers (BCRNFs) have received increasing attention due to their ability to improve nitrogen-use efficiency (NUE) and increase crop yields. We previously developed a novel BCRNF, but its effects on soil microbes, NUE, and crop yields have not been reported. Therefore, we designed a pot experiment with five randomised treatments: CK (without urea and biochar), B (addition biochar without urea), B + U (biochar mixed urea), Urea (addition urea without biochar), and BCRNF (addition BCRNF), to investigate the effects of BCRNF on nitrifiers and denitrifiers, and how these impact nitrogen supply and NUE. Results of high-throughput sequencing revealed bacterial community groups with higher nutrient metabolic cycling ability under BCRNF treatment during harvest stage. Compared to Urea treatment, BCRNF treatment stimulated nitrification by increasing the copy number of the bacterial amoA gene and reducing nitrous oxide emission by limiting the abundance of nirS and nirK. Eventually, BCRNF successfully enhanced the yield (~ 16.6%) and NUE (~ 58.79%) of rape by slowly releasing N and modulating the abundance of functional microbes through increased soil nitrification and reduced denitrification, as compared with Urea treatment. BCRNF significantly improved soil NO3-, leading to an increase in N uptake by rape and NUE, thereby promoting rape growth and increasing grain yield.

Novel method to estimate the appropriate dosing interval for activated charcoal to avoid interaction with other drugs.

PURPOSE: Activated charcoal is known to adsorb a variety of drugs concomitantly administered and reduce their intestinal absorption, and separating the dosing is considered a practical approach to avoid this drug interaction. The aim of the present study was to develop and validate a simple method to estimate the sufficient dosing interval to avoid drug interaction using the pharmacokinetic profile of the subject drugs administered alone and the amplitude of interaction upon simultaneous administration with activated charcoal. METHODS: For each subject drug, the pharmacokinetic profile and the amplitude of interaction, as assessed by AUCR (the ratio of area under the plasma concentration-time curve (AUC) in the presence of activated charcoal to that in its absence), were collected from previous reports. The AUCR value was estimated based on the compartment model under the assumption that the subject drug in the first gastrointestinal compartment is immediately adsorbed to a certain extent upon the administration of activated charcoal. The estimated AUCR (AUCRe) for each drug with certain dosing interval was compared with the respective AUCR value reported previously (AUCRobs). RESULTS: Among twenty concentration profiles for 14 subject drugs obtained from previous reports, 15 AUCRe values fell in the range of 80-120% of the respective AUCRobs values. CONCLUSION: The developed method enabled estimation of the amplitude of DDI by activated charcoal administered in a certain dosing interval, whereas overestimation of AUCRe was observed for drugs that undergo extensive enterohepatic circulation.

Evaluación del impacto glucémico de una formulación líquida de carbón activado en pacientes con intoxicación medicamentosa aguda / Blood glucose level after infusing an activated charcoal suspensionfor acute drug poisoning

OBJETIVO: La suspensión líquida de carbón activado (CA) contiene como excipiente 600 mg/mL de sacarosa. Se eva¬lúa el impacto glucémico de la administración de CA en pacientes con intoxicación medicamentosa aguda (IMA). MÉTODO: Se identificaron pacientes con IMA y determinación de la glucemia antes y después de haber recibido CA. Se compararon estos cambios de glucemia con los generados por el desayuno en un grupo control de no intoxicados. RESULTADOS: Se incluyeron 55 IMA. En el 82% de los casos la glucemia aumentó tras administrar CA. La media de las glucemias previas al carbón fue de 98,2 mg/dL y a la hora posterior de 124,2 mg/dL (p < 0,001). El cambio glucémico no condicionó eventos clínicos adversos. En el grupo control (n = 23) la glucemia aumentó en el 82,6% de los casos. La media de las glucemias antes del desayuno fue de 117,1 mg/dL y la posterior de 152,0 mg/dL (p < 0,001). CONCLUSIÓN: La administración de CA induce un aumento estadísticamente significativo de la glucemia, pero sin rele¬vancia clínica y equiparable al producido por un desayuno

OBJECTIVE: Activated charcoal in suspension contains 600 mg/mL of sucrose. We aimed to assess the impact of an activated charcoal suspension on blood glucose levels in patients with acute medication poisoning. METHODS: We identified drug patients whose blood glucose levels were measured before and after administration of activated charcoal to treat poisoning. The impact on blood glucose level was compared to changes after breakfast in a control group not receiving treatment for poisoning. RESULTS: Fifty-five poisoned patients were included. Eighty-two percent had higher blood glucose levels after activated charcoal administration. The mean glucose levels before and 1 hour after treatment were 98.2 mg/dL and 124.2 mg/dL, respectively (P<.001). The increase did not translate to adverse clinical events. Glucose levels increased in 82.6% of the 23 patients in the control group. Mean glucose levels before breakfast and 1 hour later were 117.1 mg/dL and 152.0 mg/dL (P<.001). CONCLUSION: Activated charcoal induces an increase in blood glucose level that is statistically but not clinically significant. The increase is comparable to the increase after breakfast

Treatment of ibuprofen intoxication with charcoal haemoperfusion in two dogs.

Case history: Two dogs presented separately to the Small Animal Hospital, University of Florida (Gainsville, FL, USA) for ingestion of ibuprofen. The first dog ingested 561.8 mg/kg ibuprofen in addition to paracetamol and caffeine and vomited prior to admission. This patient also received fluid therapy for 8 hours prior to charcoal haemoperfusion. The second dog ingested 500 mg/kg of ibuprofen and the owners induced vomiting with hydrogen peroxide prior to presentation. Due to the severity of clinical signs, both patients were treated with charcoal haemoperfusion.Clinical findings: The concentrations of ibuprofen in the blood of the dogs prior to treatment were 478 and 301 mg/L. During the treatment ibuprofen concentrations were reduced by 95.8% and 45.5%, respectively, with no treatment side effects and minimal clinical signs after treatment.Diagnosis: Toxicity due to ingestion of ibuprofen toxicity that was successfully treated with charcoal haemoperfusion.Clinical relevance: In the cases described here minimal benefit was seen after 3 hours of treatment using one haemoperfusion cartridge. This is in contrast to a previously published report in which dogs were treated for 6 hours with two charcoal haemoperfusion cartridges. This suggests that one cartridge may be sufficient. The amount of ibuprofen ingested was not a reliable predictor of the concentration in blood at the initiation of treatment. Charcoal haemoperfusion is an effective means of reducing plasma concentrations of ibuprofen, however, its use may be limited by its cost and availability.

Biochar enhances bioelectrochemical remediation of pentachlorophenol-contaminated soils via long-distance electron transfer.

The soil bioelectrochemical system (SBES) is a promising biotechnology for the remediation of contaminated soils. However, the effective distance of pollutant removal in the SBES was usually limited in a few centimeters near the electrode surface. In this study, we used biochar as the model conductor to construct a conductive network with microbes in the soil matrix to extend the effective distance of pollutant removal in the SBES. Pentachlorophenol (PCP) was used as the representative contaminant to probe long-distance electron transfer facilitated by the networks. The removal of PCP and microbial community analyses at different distances toward the electrode were monitored. The results showed that PCP transformation in the SBES without biochar amendment mainly occurred within 4 cm around the electrode. However, the effective distance of ∼ 16 cm toward the electrode could be achieved for efficient PCP degradation in the SBES amended with highly conductive biochar. Microbial community analysis confirmed the establishment of bacteria-biochar networks, where Desulfitobacterium and Geobacter were enriched and spatially distributed in the biochar-amended SBES. The results demonstrate that long-distance electron transfer can be achieved in the biochar-amended soil matrix, and shed light on the development of bioelectrochemical strategy for efficient organic pollutant degradation in soils.

Leucoencefalopatía posterior reversible tras sobredosis de carbimida / Posterior reversible leukoencephalopathy after cyanamide overdose

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The role of biochars in sustainable crop production and soil resiliency.

Biochar is a promising soil additive for use in support of sustainable crop production. However, the high level of heterogeneity in biochar properties and the variations in soil composition present significant challenges to the successful uptake of biochar technologies in diverse agricultural soils. An improved understanding of the mechanisms that contribute to biochar-soil interactions is required to address issues related to climate change and cultivation practices. This review summarizes biochar modification approaches (physical, chemical, and biochar-based organic composites) and discusses the potential role of biochar in sustainable crop production and soil resiliency, including the degradation of soil organic matter, the improvement of soil quality, and reductions in greenhouse gas emissions. Biochar design is crucial to successful soil remediation, particularly with regard to issues arising from soil structure and composition related to crop production. Given the wide variety of feedstocks for biochar production and the resultant high surface heterogeneity, greater efforts are required to optimize biochar surface functionality and porosity through appropriate modifications. The design and establishment of these approaches and methods are essential for the future utilization of biochar as an effective soil additive to promote sustainable crop production.

Utility of Activated Carbon Nanoparticle (CNP) During total Thyroidectomy for Clinically Nodal Positive Papillary Thyroid Carcinoma (PTC).

BACKGROUND: Activated carbon nanoparticle (CNP) is a novel tracer that may facilitate nodal dissection in clinically nodal positive (cN1) papillary thyroid carcinoma (PTC). The present study compared the nodal yield and surgical outcomes between surgery with CNP and without CNP. METHODS: Patients who underwent total thyroidectomy with therapeutic nodal dissection for cN1 PTC were given the option of intraoperative CNP injection. Among those who received CNP, 0.2 mL CNP suspension was injected in both thyroid lobes before dissection. Study endpoints included number of total and metastatic lymph nodes, inadvertently removed parathyroid glands (PGs), postoperative parathyroid hormone, calcium, and post-6-month thyroglobulin (Tg). Biochemical complete response (BCR) was defined as Tg ≤ 1 ng/mL and/or stimulated Tg ≤ 2 ng/mL. RESULTS: One-hundred and twenty patients (58.3%) received CNP, while 86 (41.7%) had surgery without CNP. Demographics, tumor characteristics, and operative time were comparable between the two groups. However, total mean number of normal and metastatic lymph nodes retrieved were significantly greater in CNP group (10.0 vs. 8.1, p = 0.032 and 4.5 vs. 2.7, p = 0.002, respectively). Rate of inadvertently removed PG was significantly less in CNP group (13.3% vs. 23.3%, p = 0.042). Postoperative Tg level and BCR were significantly lower in CNP group (9.9 ng/mL vs. 14.7 ng/mL, p = 0.297 and 82.4% vs. 72.9%, p = 0.002, respectively). However, large-sized ( ≥ 3 cm) PTCs had a significantly lower nodal staining rate than smaller-sized PTCs (10.3% vs. 69.4%, p < 0.001). CONCLUSIONS: CNP injection can facilitate therapeutic central nodal dissection by increasing the nodal yield rates and reducing inadvertent PG removal. To enhance its utility, a greater volume of CNP might be necessary in larger-sized (> 3 cm) PTCs.