The effect of selenium supplementation on sonographic findings of salivary glands in papillary thyroid cancer (PTC) patients treated with radioactive iodine: study protocol for a double-blind, randomized, placebo-controlled clinical trial.

BACKGROUND: Thyroid cancer is a very damaging disease. The most common treatment for this disease includes thyroidectomy and then using radioactive iodine (RAI). RAI has many side effects, including a decrease in salivary secretions, followed by dry mouth and oral and dental injuries, as well as increased inflammation and oxidative stress. Selenium can be effective in these patients by improving inflammation and oxidative stress and by modulating salivary secretions. So far, only one clinical trial has investigated the effect of selenium on thyroid cancer patients treated with radioiodine therapy (RIT) conducted on 16 patients; considering the importance of this issue, to show the potential efficacy of selenium in these patients, more high-quality trials with a larger sample size are warranted. METHODS: This is a parallel double-blind randomized controlled clinical trial that includes 60 patients aged 20 to 65 years with papillary thyroid cancer (PTC) treated with RAI and will be conducted in Seyyed al-Shohada Center, an academic center for referral of patients to receive iodine, Isfahan, Iran. Thirty patients will receive 200 µg of selenium for 10 days (3 days before to 6 days after RAI treatment) and another 30 patients will receive a placebo for the same period. Sonographic findings of major salivary glands, salivary secretions, and sense of taste will be evaluated before and 6 months after 10-day supplementation. DISCUSSION: Due to its anti-inflammatory and antioxidant effects, as well as improving salivary secretions, selenium may improve the symptoms of thyroid cancer treated with radioactive iodine. In past studies, selenium consumption has not reduced the therapeutic effects of radiation therapy, and at a dose of 300 to 500 µg/day, it has not had any significant side effects in many types of cancer under radiation therapy. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20201129049534N6 . Registered on 16 September 2021.

New cut-off point for D-dimer in the diagnosis of pulmonary embolism during pregnancy.

BACKGROUND: Considering that pulmonary embolism (PE) is one of the leading causes of mortality among pregnant women and that the D-dimer level in pregnancy can be highly fluctuating, a new and reliable D-dimer reference value is essential to identifying PE in this group of patients. Hence, the present study aimed to evaluate the diagnostic effect of D-dimer testing in pregnant women with suspected PE. METHODS: This study recruited 100 women with confirmed pregnancy or six weeks after delivery or abortion with suspected PE symptoms. Wells criteria, D-dimer values, and pregnancy trimesters were recorded. Definitive PE results were obtained using multidetector computed tomography (MDCT) or pulmonary ventilation/perfusion scans. RESULTS: D-dimer cut-off point in PE diagnosis was higher than 1,447 µg/L [sensitivity, 87.5%; specificity, 63.04%; area under the curve (AUC)=0.735; P =0.003]. In addition, the combination of Wells criteria with the D-dimer test indicated that the cut-off points of D-dimer in PE likely and unlikely women were 1,962 and 1,447 µg/L, respectively, and had acceptable and significant diagnostic value in PE detection. In addition, the diagnostic value of D-dimer in pregnancy trimesters was not found to be significant (P ＞0.05). CONCLUSION: The new cut-off points of 1,447 and 1,962 µg/L were determined for D-dimer in pregnant women with likely and unlikely PE, respectively. Moreover, the new cut-off points in the first and second trimesters of pregnancy were 1,701 µg/L and 1,451 µg/L, respectively, which indicated no statistically acceptable diagnostic value.

Prevalence of interleukin-28B single nucleotide polymorphism genotypes in patients with hepatitis C infection in Isfahan, Iran.

BACKGROUND: Hepatitis C infection is one of the most common causes of liver-related morbidity and mortality. Due to limited efficacy and side-effects of treatment, identification of the determinants of response to treatment is an important issue. Nowadays, genotyping of interleukin (IL)-28B is one of the strongest tests used for prediction of sustained virological response. The prevalence of IL28B genotypes varies across different ethnicities. This study presents data on IL28B single nucleotide polymorphism (SNP) (rs12979860) in a group of Iranian hepatitis C virus (HCV)-infected patients in Isfahan. MATERIALS AND METHODS: One hundred patients already diagnosed for hepatitis C enrolled the study. Genomic DNA was extracted from whole blood samples. Specific primers were used to amplify IL28B gene (rs12979860). The rs129679860 SNP was genotyped by real-time polymerase chain reaction using TaqMan(®) probes. RESULTS: The mean age of patients was 33.16 years (25-42 years). Ninety-nine subjects were male and 1 was female. The frequency of HCV genotypes was as follows: Genotype 3a: 53%, genotype 1a: 42%, genotype 1b: 2%, mixed genotype (1a + 3a): 1% and 2%: Nontypable. IL28B rs12979860 genotypes were TT in 17 patients (17%), CT in 41 patients (41%), and CC in the remaining 42 patients (42%). CONCLUSION: The prevalence of C allele is much higher in our population study than in African American HCV patients (62.5% and 40% respectively), which can explain better response to treatment in our patients.