Body composition changes in patients with differentiated thyroid cancer after iodine-131 treatment and short-term levothyroxine replacement and suppression therapy.

PURPOSE: The purposes of this study were to assess the changes in body composition in patients who underwent thyroidectomy due to differentiated thyroid cancer (DTC) after radioactive iodine therapy (RAI) and short-term levothyroxine (LT4) supplementation and to explore the correlations between body composition distribution and corresponding blood indices. METHODS: Fifty-seven thyroidectomized DTC patients were included. Serum was tested for several biochemical indices of thyroid function, lipids, and bone metabolism, and body composition parameters were measured via dual-energy X-ray absorptiometry before and 4-6 weeks after RAI and LT4 supplementation. RESULTS: The body composition of DTC patients changed after RAI. Fat mass in all parts of the body decreased (range of relative change (RRC) -12.97--2.80%). Bone mineral content (BMC) increased throughout the body (relative change (RC) 12.12%), head (RC 36.23%), pelvis (RC 9.00%), and legs (RC 3.15%). Similarly, bone mineral density (BMD) increased in different regions (RRC 3.60-26.43%), except for the arms. Notably, lean mass in the arms (RC 4.30%) and legs (RC 3.67%) increased, while that in the head decreased (RC -2.75%), while total lean mass did not change at 4-6 weeks after LT4 supplementation. Furthermore, changes in fat distribution in the android region were related to the changes in total cholesterol (r = -0.390) and low-density lipoprotein cholesterol (r = -0.354), and changes in the BMC and BMD of the lumbar spine were positively associated with the changes in calcitonin (r = 0.302 and 0.325, respectively). CONCLUSIONS: After RAI and short-term LT4 supplementation in DTC patients, body composition rapidly and positively changed and was characterized by decreased fat mass and increased BMC and BMD.

THE OCCURRENCE OF ACUTE PANCREATITIS AFTER IODINE 131 TREATMENT OF HYPERTHYROIDISM.

Acute pancreatitis is a common and potentially fatal gastrointestinal disease. We report a case of acute pancreatitis induced by iodine-131 therapy for hyperthyroidism. Iodine 131 is distributed through the blood, so it can accumulate and damage normal tissues in other parts of the body that are involved in thyroid hormone metabolis.

Psychological and behavioral intervention improves the quality of life and mental health of patients suffering from differentiated thyroid cancer treated with postoperative radioactive iodine-131.

BACKGROUND: We examined the effects of psychological and behavioral intervention on health-related quality of life and mental health among patients suffering from differentiated thyroid cancer (DTC) treated with postoperative radioactive iodine-131 (RAI). METHODS: Sixty patients with DTC, undergoing RAI, were randomly assigned to receive either conventional nursing (n=30) or a 1-year psychological and behavioral intervention based on conventional nursing (n=30). Health-related quality of life and mental health issues, depression, and anxiety were measured using the Quality of Life Core Questionnaire, Self-rating Depression Scale, and Self-rating Anxiety Score, respectively. RESULTS: After RAI treatment, patients in both groups showed improved functional capacities (ie, physical, role, cognitive, emotional, and social) and global quality of life, along with reduced depression and anxiety (P<0.05). At 1-year follow-up, compared with patients in the routine nursing group, those in the psychological and behavioral intervention group demonstrated greater improvements in functional capacities, global quality of life, and depression and anxiety symptoms (P<0.05). CONCLUSION: Psychological and behavioral interventions for patients with DTC undergoing RAI facilitated positive outcomes, suggesting that nursing care models that include psychological and behavioral interventions may be a complementary strategy for this patient population.

Different beginning time of acid stimulation to reduce the acute damage of salivary glands after high-dose iodine-131 therapy for the post-surgery DTC patients / 重庆医学

Objective To compare different beginning time of acid simulation to reduce the acute damage of salivary glands after high-dose of iodine-131 treatment for the post-surgery patient with differentiated thyroid cancer (DTC) and screen out the optimal beginning time of acid simulation .Methods Total 309 cases of post-surgery DTC patients accept high-does ioding-131 treatment (average dose of ioding-131 :4 .28 ± 0 .43 GBq) ,and all patients was divided into three group randomly ,the beginning time of acid stimulation(vitamin C :10 mg per time ,three time a day ,lemonade:50 mL per 2 h) for each group is 2 ,12 and 24 h .Then observe the incidence and time of acute damage of salivary glands for each group .At same time ,we analyses the relation between acute dam-age of salivary glands with sex and age .Results The incidence of acute damage of salivary glands is 13 .21% (2 h) ,24 .51% (12 h) , 26 .73% (24 h)respectively ,the incidence of 2 h is lower than those of 12 h and 24 h obviously(P0 .05) .The occurrence time of acute damage of salivary glands for 84 .85% patients is between 10-24 h .And there is no difference of incidence of acute damage of salivary glands between different sex and age group .Conclusion 2 h maybe the optimal beginning time of acid simulation to reduce the acute damage salivary glands for the post-surgery DTC patients after high-dose iodine-131 treatment in this study .Sex and age are no influence to the occurrence of acute damage of salivary glands .

The clinical experience of total thyroidectomy in the treatment of thyroid carcinoma / 临床外科杂志

Objective To evaluate the therapeutic value of total thyroidectomy in the thyroid carcinoma.Methods 87 patients of thyroid carcinoma were operated by one surgeon with total thyroidectomy from 1985-2000 in our hospital, We carried out a retrospective research for the complication rates and postoperative iodine 131 treatment. Results Observing after operation revealed that there were 2(2.3%) of recurrent laryngeal nerve damage, 1(1.1%) of thypocalecimia, 1(1.1%) of atelectasis, and no deaths, permanent laryngeal nerve damage, or permanent hypocalcemia.Conclusion Total thyroidectomy is safe and effective procedure in the treatment of thyroid carcinoma, this approach can offer the advantage of removal of tissue at risk for malignant transformation,and enhances the use of the postoperative iodine 131 treatment.