scholarly journals Detection of Simple, Complex, and Clonal Chromosome Translocations Induced by Internal Radioiodine Exposure: A Cytogenetic Follow-Up Case Study after 25 Years

2019 ◽  
Vol 159 (4) ◽  
pp. 169-181 ◽  
Author(s):  
Gordon K. Livingston ◽  
Terri L. Ryan ◽  
Tammy L. Smith ◽  
Maria B. Escalona ◽  
Alvis E. Foster ◽  
...  
Keyword(s):  
Chromosomal Instability ◽  
Banding Technique ◽  
Radioiodine Treatment ◽  
Multicolor Fish ◽  
Chromosome Translocations ◽  
Multicolor Banding ◽  
Balanced Translocations ◽  
First Time

Here, we report the findings of a 25-year cytogenetic follow-up study on a male patient who received 2 rounds of radioiodine treatment within a span of 26 months (1.78 GBq in 1992 and 14.5 GBq in 1994). The patient was 34 years old with a body mass index of 25 at the time of the first radioiodine treatment. Multicolor FISH and multicolor banding (mBAND) techniques performed on the patient detected inter- and intrachromosomal exchanges. Although the frequency of chromosome translocations remained essentially the same as reported in our earlier study (0.09/cell), the percentage of reciprocal (balanced) translocations increased from 54.38 to 80.30% in the current study. In addition to simple chromosome translocations, complex exchanges (0.29%) involving more than 2 chromosomes were detected for the first time in this patient. Strikingly, a clonal translocation involving chromosomes 14 and 15, t(14p;15q), was found in 7 of the 677 cells examined (1.03%). The presence of complex and clonal translocations indicates the onset of chromosomal instability induced by internal radioiodine exposure. mBAND analysis using probes specific for chromosomes 1, 2, 4, 5, and 10 revealed 5 inversions in a total of 717 cells (0.69%), and this inversion frequency is several-fold higher than the baseline frequency reported in healthy individuals using the classical G-banding technique. Collectively, our study suggests that stable chromosome aberrations such as translocations and inversions can be useful not only for retrospective biodosimetry but also for long-term monitoring of chromosomal instability caused by past radioiodine exposure.

Long-term follow-up of differentiated thyroid carcinoma in children and adolescents

2020 ◽  
Vol 33 (11) ◽  
pp. 1431-1441
Author(s):  
Montserrat Negre Busó ◽  
Amparo García Burillo ◽  
Marc Simó Perdigó ◽  
Pere Galofré Mora ◽  
Maria Boronat de Ferrater ◽  
...  
Keyword(s):  
Complete Remission ◽  
Thyroid Carcinoma ◽  
Children And Adolescents ◽  
Differentiated Thyroid Carcinoma ◽  
Radioiodine Treatment ◽  
Persistent Disease ◽  
Stage 4 ◽  
Long Term Follow Up

AbstractObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC).MethodsEighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated.ResultsSeventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after first radioiodine treatment, 36.2% of patients were free of disease. Seven recurrences were documented. At the end of follow-up, overall survival was 100%, and 87.2% of patients were in complete remission. Nine patients had persistent disease. We found a significant association between stage 4 and persistent disease. Hundred percent of patients with negative Tg values at 6 months posttreatment were documented free of disease at the end of the follow-up. The analysis of disease-free survival based on radioiodine treatment protocols used showed no statistically significant differences.ConclusionsDTC in children and adolescents is frequently associated with presence of advanced disease at diagnosis. Despite this, complete remission was documented after treatment in most cases, with a good prognosis in the long-term follow-up. Negative posttreatment thyroglobulin and stage 4 at diagnosis were significant prognostic variables.

Magnitude of bacteraemia is a predictor of mortality during 1 year of follow-up

2008 ◽  
Vol 137 (1) ◽  
pp. 94-101 ◽  
Author(s):  
K. O. GRADEL ◽  
M. SØGAARD ◽  
C. DETHLEFSEN ◽  
H. NIELSEN ◽  
H. C. SCHØNHEYDER
Keyword(s):  
Surgical Patients ◽  
Adjusted Risk ◽  
High Magnitude ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Cox's Regression ◽  
First Time ◽  
Long Term Mortality

SUMMARYWe evaluated magnitude of bacteraemia as a predictor of mortality, comprising all adult patients with a first-time mono-microbial bacteraemia. The number of positive bottles [1 (reference), 2, or 3] in the first positive blood culture (BC) was an index of magnitude of bacteraemia. We used Cox's regression analysis to determine age and comorbidity adjusted risk of mortality at days 0–7, 8–30, and 31–365. Of 6406 patients, 31·1% had BC index 1 (BCI 1), 18·3% BCI 2, and 50·6% BCI 3. BCI 3 patients had increased risk of mortality for days 0–7 (1·30, 95% CI 1·10–1·55) and days 8–30 (1·37, 95% CI 1·12–1·68), but not thereafter. However, in surgical patients mortality increased only beyond day 7 (8–30 days: 2·04, 95% CI 1·25–3·33; 31–365 days: 1·27, 95% CI 0·98–1·65). Thus, high magnitude of bacteraemia predicted mortality during the first month with a shift towards long-term mortality in surgical patients.

Papillary thyroid carcinoma with exuberant nodular fasciitis-like stroma: treatment outcome and prognosis

2006 ◽  
Vol 120 (4) ◽  
pp. 338-342 ◽  
Author(s):  
S Basu ◽  
N Nair ◽  
T Shet ◽  
A M Borges
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Clinical Course ◽  
Nodular Fasciitis ◽  
Rare Entity ◽  
Papillary Thyroid ◽  
Radioiodine Treatment ◽  
Long Term Follow Up

Papillary thyroid carcinoma with nodular fasciitis-like stroma (PTC-NFS) is one of the extremely rare variants of papillary thyroid carcinoma. To date, the majority of reported cases have been published in the surgical pathology and cytopathology literature, addressing the diagnostic difficulties posed by the condition's extensive, reactive stromal proliferation. Because of the rarity of PTC-NFS among papillary thyroid carcinoma variants, it has been unexplored from a clinical viewpoint. A MEDLINE search on the clinical course, role of radioiodine, treatment outcome and long term follow up of this disease yielded no result.We report the clinicoradiologic and histopathologic profile, together with post-treatment long term follow up, in a 35-year-old woman harbouring this rare entity. To the best of our knowledge, this is the first report of a five-year follow up of this rare variant of PTC following total thyroidectomy and radioiodine treatment. Our follow-up findings reiterate the disease's favourable clinical course when managed in the same manner as a classical, differentiated papillary carcinoma of the thyroid, akin to that predicted by the pathologists, and emphasize the importance of differentiating PTC-NFS as a separate entity from the papillary carcinoma variants with aggressive histology. Given the rarity of this condition, the experience gained from the present case is a useful addition to the current knowledge on disease prognostication and management.A systematic review of the existing literature on PTC-NFS, including the case reported in the present paper, is also carried out, aiming to explore the patient characteristics and clinical behaviour pattern of this rare entity and to make appropriate recommendations on management strategy. The age of presentation ranges from 20 to 82 years, with a mean of 44.5 years. Female preponderance was observed, with a female to male ratio of 3[ratio ]1. No racial predilection was observed. Tumour size varied from 2 to 9 cm along its greatest diameter (mean = 4.3 cm). Metastasis to lymph nodes at presentation occurred in 25 per cent of cases. Metastasis to surrounding structures (e.g. parathyroid and skeletal muscle) was observed in 12.5 per cent. There have been no reports of pulmonary or skeletal metastasis at presentation.

Teenage motherhood and risk of premature death: long-term follow-up in the ONS Longitudinal Study

2011 ◽  
Vol 41 (9) ◽  
pp. 1867-1877 ◽  
Author(s):  
R. T. Webb ◽  
C. E. Marshall ◽  
K. M. Abel
Keyword(s):  
Longitudinal Study ◽  
Social Services ◽  
Reference Group ◽  
Suicide Mortality ◽  
Psychosocial Needs ◽  
Teenage Motherhood ◽  
Long Term Follow Up ◽  
First Time

BackgroundTeenage motherhood is relatively common in the UK, but little is known about related health inequalities in this population. We estimated cause-specific mortality risks over three decades in a nationally representative cohort.MethodWe examined premature mortality in a 1.1% sample of all women who were teenagers in England and Wales during the 1970s, 1980s and 1990s using data from the Office for National Statistics Longitudinal Study (ONS LS). Our primary outcome was suicide. Long-term follow-up to 31 December 2006, to a potential maximum age of 49 years, was achieved through near-complete routine linkage to national mortality records. We created a time-dependent exposure variable, with relative risks estimated according to age when women first experienced motherhood versus a reference group of those currently without children.ResultsWomen who were teenage mothers were around 30% more likely to die prematurely by any cause and almost 60% more likely to die unnaturally, whereas first-time motherhood at mature age conferred lower risk compared to women without children. Teenage motherhood was associated with a more than doubled risk of suicide [mortality rate ratio (MRR) 2.23, 95% confidence interval (CI) 1.30–3.83], and elevated risks of fatal cancer of the cervix and lung were also found. Changing the reference category to first-time mothers at 20 years and above also revealed a significant elevation in risk of accidental death.ConclusionsThe complex psychosocial needs of these women require greater attention from clinicians, public health professionals, social services and policymakers. Their elevated risk of poor health outcomes may persist well beyond the actual teenage motherhood years.

scholarly journals Assessment of the potential damaging effect of radiofrequency exposure in children in prospective follow-up (case report series)

2020 ◽  
Vol 35 (3) ◽  
pp. 116-124
Author(s):  
O. Yu. Dzhaffarova ◽  
L. I. Svintsova ◽  
I. V. Plotnikova ◽  
S. N. Krivolapov ◽  
E. O. Kartofeleva
Keyword(s):  
Electrophysiological Study ◽  
Electrical Signal ◽  
Coagulation Necrosis ◽  
Early Age ◽  
Follow Up Study ◽  
Rf Exposure ◽  
First Time ◽  
New Onset

Aim: To evaluate the electrical activity of the myocardium and the radiofrequency (RF) application zone resulting from radiofrequency ablation (RFA) performed at an early age.Material and Methods. A prospective follow-up study included three patients who underwent intracardiac electrophysiological study (EPS) and effective RFA of the tachycardia for the first time at an early age. A reintervention was required in one case 12 years after the procedure and in two cases six years after it due to recurrent and new-onset arrhythmias. During the reintervention, electroanatomical mapping was performed to assess the potential damaging effect of radiofrequency exposure in the area of the first ablation.Results. The intracardiac EPS and amplitude bipolar CARTO-reconstruction of primary ablation area were performed during repeated RFA procedure. The study showed that neither zones with a decrease in the amplitude of electrical signal from the myocardium nor silent electrical zones were present ruling out the cicatricial-sclerotic changes in the myocardium in children in the long-term period after RF exposure.Conclusion. The study showed that no increase in the coagulation necrosis zone in the area of primary ablation occurred during the growth of child when the sparing energy and temperature parameters of RFA and the limited number of RF applications were used. Further research in this area is required.

Factors Predicting Hypothyroidism in Long-Term Follow-Up after131I Therapy

1988 ◽  
Vol 27 (04) ◽  
pp. 135-139 ◽  
Author(s):  
M. Critchley ◽  
C. R. Squire ◽  
T. M. D. Gimlette
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Elevated Serum ◽  
Thyroid Autoantibodies ◽  
Radioiodine Treatment ◽  
Long Term Follow Up ◽  
Serum Tsh

187 patients, euthyroid for more than a year after radioiodine treatment for hyperthyroidism, were studied for 10 years; 81 (43%) became hypothyroid. The incidence of hypothyroidism was lower in patients initially presenting with large thyroids (28%) or with nodular thyroids (22%) and in those without thyroid autoantibodies (31 %). During follow-up, an elevated serum TSH was present in all 81 patients when they became hypothyroid (sensitivity and negative predictive value 100%), and was present for at least a year in 98% of these. However, an elevated serum TSH was also present in 48% of 106 patients remaining euthyroid (positive predictive value 61 %). FT4I was low in 94% of patients who became hypothyroid and normal in 80% of patients who remained euthyroid (positive predictive value 78%, negative predictive value 93%). Serum TSH and FT4I were the best biochemical predictors. FT3I and serum cholesterol were less satisfactory. A palpable thyroid becoming impalpable, though readily assessed, was limited in usefulness. Clinical appraisal remains important and a progressive, though perhaps less rapid, later increase in the incidence of hypothyroidism appears likely.

scholarly journals Three-Dimensional Volumetric Restoration by Structural Fat Grafting

2014 ◽  
Vol 7 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Luigi C. Clauser ◽  
Giuseppe Consorti ◽  
Giovanni Elia ◽  
Manlio Galié ◽  
Riccardo Tieghi
Keyword(s):  
Adipose Tissue ◽  
Three Dimensional ◽  
Fat Grafting ◽  
Fat Injection ◽  
Facial Esthetics ◽  
Long Term Follow Up ◽  
The 19Th Century ◽  
First Time

The use of adipose tissue transfer for correction of maxillofacial defects was reported for the first time at the end of the 19th century. Structural fat grafting (SFG) was introduced as a way to improve facial esthetics and in recent years has evolved into applications in craniomaxillofacial reconstructive surgery. Several techniques have been proposed for harvesting and grafting the fat. However, owing to the damage of many adipocytes during these maneuvers, the results have not been satisfactory and have required several fat injection procedures for small corrections. The author's (L.C.) overview the application of SFG in the management of volumetric deficit in the craniomaxillofacial in patients treated with a long-term follow-up.

scholarly journals The Future of the Time Domain with LSST

2011 ◽  
Vol 7 (S285) ◽  
pp. 158-158
Author(s):  
Lucianne M. Walkowicz
Keyword(s):  
Time Domain ◽  
Survey Design ◽  
Ancillary Data ◽  
Event Identification ◽  
Scientific Investigations ◽  
The Time Domain ◽  
First Time

SummaryIn the coming decade LSST's combination of all-sky coverage, consistent long-term monitoring and flexible criteria for event identification will revolutionize studies of a wide variety of astrophysical phenomena. Time-domain science with LSST encompasses objects both familiar and exotic, from classical variables within our Galaxy to explosive cosmological events. Increased sample sizes of known-but-rare observational phenomena will quantify their distributions for the first time, thus challenging existing theories. Perhaps most excitingly, LSST will provide the opportunity to sample previously untouched regions of parameter space. LSST will generate ‘alerts’ within 60 seconds of detecting a new transient, permitting the community to follow up unusual events in greater detail. However, follow-up will remain a challenge as the volume of transients will easily saturate available spectroscopic resources. Characterization of events and access to appropriate ancillary data (e.g. from prior observations, either in the optical or in other passbands) will be of the utmost importance in prioritizing follow-up observations. The incredible scientific opportunities and unique challenges afforded by LSST demand organization, forethought and creativity from the astronomical community. To learn more about the telescope specifics and survey design, as well as obtaining a overview of the variety of the scientific investigations that LSST will enable, readers are encouraged to look at the LSST Science Book: http://www.lsst.org/lsst/scibook. Organizational details of the LSST science collaborations and management may be found at http://www.lsstcorp.org.

scholarly journals Traumatic Patellar Dislocation and Cartilage Injury: A Follow-up Study of Long-Term Cartilage Deterioration

2017 ◽  
Vol 45 (6) ◽  
pp. 1376-1382 ◽  
Author(s):  
Essi E. Salonen ◽  
Teemu Magga ◽  
Petri J. Sillanpää ◽  
Tommi Kiekara ◽  
Heikki Mäenpää ◽  
...  
Keyword(s):  
Patellofemoral Joint ◽  
Patellar Dislocation ◽  
Cartilage Injury ◽  
Cartilage Lesions ◽  
Patellar Cartilage ◽  
Lateral Patellar Dislocation ◽  
First Time ◽  
And Cartilage

Background: Patellofemoral cartilage deterioration and osteoarthritis are reported to be associated with recurrent patellar dislocation. However, the association between first-time traumatic patellar dislocation and cartilage deterioration is unknown. Purpose: The aim of this study was to assess long-term cartilage deterioration in the patellofemoral and tibiofemoral joint after conservatively treated traumatic lateral patellar dislocation. Study Design: Case series; Level of evidence, 4. Methods: Twenty patients (mean age, 25 years) who sustained first-time traumatic lateral patellar dislocation with no previous patellofemoral instability symptoms were initially scanned with 1.5-T magnetic resonance imaging (MRI). A follow-up 3-T MRI was conducted, on average, 8 years after first-time lateral patellar dislocation. Subjective instability symptoms and Knee injury and Osteoarthritis Outcome Score were also assessed. Results: In the primary MRI, patellofemoral cartilage injury was seen in 14 of 20 patients (70%). Most (14/15) of the injuries were seen in the patellar cartilage, especially at the medial facet. On the follow-up MRI, patellofemoral cartilage deterioration was visible for all patients. The central patella ( P = .005) seemed especially prone to cartilage deterioration during the follow-up. Half of the patients (10/20) had grade 3-4 cartilage lesions in the patellofemoral joint in the follow-up MRI. In the primary MRI, only 1 patient exhibited tibiofemoral joint cartilage lesions, whereas at the time of follow-up, 10 of 20 patients exhibited tibiofemoral cartilage lesions. The majority of these lesions were considered clinically nonsignificant (International Cartilage Repair Society = 1) and were seen in the lateral compartment (6/10, 60%). Of the 14 patients (36%) with injury to the patellar cartilage, 5 reported subsequent instability of the patellofemoral joint, but this was not associated with more significant cartilage deterioration in the follow-up MRI compared with patients without redislocation. Conclusion: While recurrent lateral patellar dislocation is known to lead to degenerative process, a single first-time or infrequently recurring traumatic lateral patellar dislocation also seems to be associated with gradual cartilage deterioration. Traumatic lateral patellar dislocation might initiate gradual degeneration of the cartilage in the patellofemoral joint and can lead to the development of generalized knee osteoarthritis. Instability symptoms of the patellofemoral joint, however, were not related to the severity of the deterioration.

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