Factors affecting timing of hypothyroidism following radioactive iodine therapy (RAIT) for patients with Graves' disease: A 12-month observational study.

BACKGROUND: This retrospective study analyzed factors influencing hypothyroidism development after radioactive iodine therapy for Graves' disease. PATIENTS AND METHODS: Three hundred and three patients with Graves' disease treated with radioactive iodine (RAI) from 2013 to 2022 at two Egyptian hospitals were included. Data collected included demographics, lab values, thyroid imaging, RAI doses, and outcomes. Patients were followed for ≥1 year to assess hypothyroidism onset. RESULTS: At the end of 1 year, around 79.5% of the individuals developed hypothyroidism while 12.5% continued to experience hyperthyroidism. The onset of hypothyroidism occurred earlier in those with thyroid volume (≤75.5 cm 3 ), lower thyroid weight (≤84.7 g), thyroid uptake (≤18.8%), and higher RAI dose/volume (≥0.1022 mCi/ml) ( P  < 0.001). Additionally, there was a correlation between anti-thyroid peroxidase (anti-TPO) antibodies and faster development of hypothyroidism compared to those who were negative for antibodies (2.9 vs 8.9 months, P  = 0.001). When considering factors in analysis it was found that anti-TPO antibodies were the only independent predictor, for developing hypothyroidism (hazard risk 30.47, P  < 0.001). Additionally, thyroid volume and uptake independently predicted successful treatment outcomes ( P  < 0.05). CONCLUSION: Positive anti-TPO antibodies strongly predict hypothyroidism risk after RAI therapy for Graves' disease. Smaller thyroid size, lower uptake, and higher RAI dose/volume correlate with earlier hypothyroidism onset but are less significant predictors than anti-TPO status. Findings can guide RAI therapy personalization to optimize outcomes.

The incorporation of sumac seed powder (Rhus coriaria L.) into the diet of quail breeders as a novel feed additive.

A total of 150 adult quails, aged 8 wk, were divided into 5 groups to study the effect of sumac seed powder on reproductive and productive parameters, egg quality, digestive enzymes, and quail breeders' blood profiles. Dietary supplements containing sumac powder were formulated as follows: group 1 (G1) (control, only basal diet); group 2 (G2) (basal diet + 1 g sumac powder/kg diet); group 3 (G3) (basal diet + 2 g sumac powder/kg diet); group 4 (G4) (basal diet + 3 g sumac powder/kg diet); and group 5 (G5) (basal diet + 4 g sumac powder/kg diet). The feed conversion ratio was significantly higher at all levels of sumac powder (P < 0.05) compared to the control group (G1). Overall, during the study (8-16 wk), quail-fed 3 g sumac powder/kg diet (G4) showed no significant increase (P > 0.05) in the feed intake compared to the control group. Sumac powder supplementation significantly (P < 0.05) increased egg number, egg weight, egg mass, fertility, and hatchability. While supplementing with sumac powder did not impact other egg quality parameters, it did significantly (P < 0.05) increase yolk percentage, Haugh unit, and unit surface shell weight. Furthermore, when compared to the control group (G1), birds given 2, 3, or 4 g of sumac powder/kg diet showed a significant improvement (P < 0.05) in hematological parameters such as red blood cells, white blood cells, and hemoglobin, as well as a decrease in glucose levels. Feeding quail with a 3 g sumac powder/kg diet (G4) resulted in significantly (P < 0.05) higher globulin levels and improved albumin/globulin ratio compared to other treatments and control (G1). Sumac powder intake significantly (P < 0.05) reduced plasma lipid profile, liver enzymes (aspartate aminotransferase, and alanine aminotransferase), and kidney functions (creatinine, and urea). Furthermore, the supplementation of sumac powder resulted in a substantial increase (P < 0.05) in the levels of amylase, lipase, and protease. Sumac powder administration also significantly (P < 0.05) improves immunity by boosting IgM, IgG, IgA, and lysozyme levels in quail breeders' plasma. Supplementing with sumac powder, on the other hand, increased levels of reduced glutathione, total antioxidant capacity, catalase, and superoxide dismutase. The results of the current study indicated that the addition of 1, 2, 3, and 4 g of sumac powder to the diet of Japanese quail breeders led to improvements in egg quality, digestive enzymes, reproductive and productive performances, and most blood hematological and biochemical parameters.

The potential of Spirulina platensis to substitute antibiotics in Japanese quail diets: impacts on growth, carcass traits, antioxidant status, blood biochemical parameters, and cecal microorganisms.

The development of antibiotic-resistant microorganisms prompted the investigation of possible antibiotic substitutes. As a result, the purpose of the current study is to assess the effect of dietary Spirulina platensis extract as an antibiotic alternative on Japanese quail (Coturnix japonica) growth, antioxidant status, blood parameters, and cecal microorganisms. There was a total of 150 Japanese quails used in this study, divided equally among 5 experimental groups (10 birds per group with 3 replicates): group 1 (G1) received a basal diet without any S. platensis extract, group 2 (G2) received a basal diet supplemented with 1 mL S. platensis extract/kg, group 3 (G3) received a basal diet supplemented with 2 mL S. platensis extract/kg, group 4 (G4) received a basal diet supplemented with 3 mL S. platensis extract/kg, and group 5 (G5) received a basal diet supplemented with 4 mL S. platensis extract/kg from d 7 until d 35. The results showed that compared to the control birds in G1, Japanese quail supplemented with 4 mL of S. platensis extract/kg of diet (G5) had significantly better live body weight, body weight gain, feed intake, feed conversion ratio, digestive enzymes, blood parameters, liver and kidney functions, lipid profile, antioxidant profile, immunological parameters, and cecal microorganism's count. There were no significant changes in the percentage of carcasses, liver, and total giblets among all the 5 groups. Only gizzard percentage showed a significant increase in G2 compared to birds in G1. In addition, intestinal pH showed a significant drop in G2 and G5 compared to birds in G1. After cooking the quail meat, the juiciness and tenderness increased as S. platensis extract levels increased, whereas aroma and taste declined slightly as S. platensis extract levels increased. Furthermore, when a high concentration of S. platensis extract was used, the lightness of the meat reduced while its redness and yellowness increased. The disk diffusion assay showed that S. platensis extract had significant antibacterial activity against Staphylococcus aureus, Listeria monocytogenes, Campylobacter jejuni, and Salmonella typhi, with inhibition zones ranging from 16 to 42 mm. This activity may be attributable to the volatile chemicals in S. platensis extract, of which Geosmin and 2-methylisoborneol are the primary components. In the diet of Japanese quails, it is possible to draw the conclusion that the extract of S. platensis can be utilized as a feed additive and as an alternative to antibiotics.

Dietary supplementation with Moringa oleifera leaves extract reduces the impacts of sub-lethal fipronil in Nile tilapia, Oreochromis niloticus.

This study assessed the restorative dietary effects of Moringa oleifera (MO) leaves extract against the negative impacts of sub-lethal fipronil (FIP) toxicity in Nile tilapia. To achieve this purpose, the growth, body composition, haemato-biochemical measurements, serum immunity, and antioxidant condition of Nile tilapia have been examined. Fish were arranged into 6 experimental groups in quadruplicates. Three groups were fed on diets supplemented with 0.0 (reference group), 1.0 (MO1), and 2.0 (MO2) g kg-1 of MO leaf extract. The other three groups were fed on the same MO levels and concomitantly subjected to a sub-lethal FIP concentration (4.2 µg L-1 for 3 h only per day) and defined as FIP, FIP + MO1, and FIP + MO2. The experiment lasted for 8 weeks. Results unveiled that growth parameters were significantly decreased alongside an increased feed conversion ratio in the FIP-intoxicated group. The moisture and crude protein (%) were decreased significantly together with a significant increase of the crude lipids (%) in the fish body of the FIP group. Sub-lethal FIP toxicity induced hypochromic anemia, leukopenia, hypoproteinemia, hypoalbuminemia, hypoglobulinemia, and hepato-renal failure (increased urea and creatinine concentrations, as well as ALT and AST enzymes). Exposure to sub-lethal FIP also induced (a) immunosuppression manifested by a decline in total IgM, complement C3, and lysozyme activities, (b) enzymatic antioxidant misbalance manifested by decreases in SOD and CAT activities, and (c) oxidative stress (declined T-AOC and elevated of MDA concentrations). On the other side, dietary supplementation with MO leaf extract in FIP + MO1 and FIP + MO2 groups noticeably modulated the aforementioned parameters. Therefore, we can conclude that dietary MO could reduce sub-lethal FIP toxicity in Nile tilapia with a possible recommendation for regular prophylaxis supplementation in Nile tilapia diets.

Volumetric parameters of the primary tumor and whole-body tumor burden derived from baseline 18F-FDG PET/CT can predict overall survival in non-small cell lung cancer patients: initial results from a single institution.

BACKGROUND: Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are volumetric parameters derived from 18F-FDG PET/CT, suggested to have a prognostic value in cancer patients. Our study aimed to test whether these volumetric parameters of the primary tumor and whole-body tumor burden (WBTB) can predict overall survival (OS) in non-small cell lung cancer (NSCLC) patients. MATERIALS AND METHODS: Thirty biopsy-proven NSCLC patients who had not begun anti-tumor therapy were included in this prospective study. A baseline 18F-FDG PET/CT study was acquired. Scans were interpreted visually and semi-quantitatively by drawing a 3D volume of interest (VOI) over the primary tumor and all positive lesions to calculate metabolic, volumetric parameters, and WBTB. The PET parameters were used to stratify patients into high- and low-risk categories. The overall survival was estimated from the date of scanning until the date of death or last follow-up. RESULTS: At a median follow-up of 22.73 months, the mean OS was shorter among patients with higher tu MTV and tu TLG and high WBTB. High WB TLG was independently associated with the risk of death (p < 0.025). Other parameters, e.g., SUVmax, SUVpeak, and SUVmean, were not predictive of outcomes in these patients. CONCLUSION: In patients with NSCLC, tu MTV, tu TLG, and WBTB determined on initial staging 18F-FDG PET/CT seems to be a strong, independent imaging biomarker to predict OS, superior to the clinical assessment of the primary tumor. The WB TLG was found to be the best predictor of OS.

Rare sites of metastases in patients with differentiated thyroid carcinoma and added value of SPECT/CT over planar whole body radioactive iodine scan.

BACKGROUND: Being aware of the unusual or rare location of thyroid metastases helps in early diagnosis and proper patient management. Rare metastases (RM) can be missed resulting in diagnostic pitfalls and delayed treatment. The use of single-photon emission computed tomography/computed tomography (SPECT/CT) imaging in the follow-up of differentiated thyroid cancer (DTC) patients provides precise anatomical localization and characterization of RM that may be missed or misinterpreted in planar whole body iodine-131 (WBI) scan. There is a lack of knowledge about dealing with such patients, the treatment they should receive, and therapy response due to the rarity of such cases. In this work, we reported these rare cases increasing awareness about them and their methods of treatment with response to therapy and evaluated the added value of SPECT/CT imaging in changing patients' management. MATERIALS AND METHODS: In this study we reviewed all patients with DTC referred to our unit either for initial radioactive iodine-131 therapy (RAIT) or under follow-up from January 2019 to January 2022. When a suspected lesion was detected in a conventional planar WBI scan whether follow-up scan or post-therapeutic scan, SPECT/CT was acquired immediately in the same session for that region. Additional imaging modalities were performed for confirmation. Response to the given treatment either disease progression (DP) or favorable response which include complete response (CR), partial regression (PR) and stable disease (SD) recorded for each patient. RESULTS: Two hundred and forty patients with DTC referred to our unit over a three-year period (from January 2019 to January 2022) were reviewed. Forty patients developed lung and bone distant metastases. Twenty-one patients were thought to have metastases at unusual sites. Due to incomplete data (no SPECT/CT pictures or confirmatory imaging), 6/21 patients were eliminated. We studied 15 patients with RM (9 females, 6 males) with a median age of 52 years (range 27-79). All patients received the initial RAIT after thyroidectomy in addition to other therapeutic modalities, e.g., radiotherapy (RTH), chemotherapy (CTH) or surgical tumor excision after detection of RM. Ten out of 15 patients (66.67%) showed favorable response to therapy (2 patients had CR, 6 patients had PR and 2 patients had SD), whereas only 5 patients had DP. Additional SPECT/CT changed management in 10/15 patients (66, 67%) of patients. CONCLUSION: RM identification is mandatory to avoid misdiagnosis and delayed therapy. Increasing the awareness about such rare cases allows for better management. SPECT/CT could significantly impact patients' management through its precise anatomic localization and lesion characterization.

Astragalus membranaceus polysaccharides modulate growth, hemato-biochemical indices, hepatic antioxidants, and expression of HSP70 and apoptosis-related genes in Oreochromis niloticus exposed to sub-lethal thallium toxicity.

A 60-day experiment was performed to assess the efficacy of dietary Astragalus membranaceus polysaccharides (ASP) in attenuation of sub-lethal thallium (Tl) toxicity in Nile tilapia. Six experimental groups (in triplicates) were designed where a fish group was raised in clean water and fed basal diet and served as control (CONT), two groups were fed the basal diet supplemented with 0.15% and 0.30% ASP (ASPL and ASPH), Tl-intoxicated group exposed to 1/10 of 96-h LC50 (= 41.9 µg/L), and two other groups were fed 0.15% and 0.30% ASP and concomitantly exposed to 41.9 µg Tl/L (ASPL-Tl and ASPH-Tl). At the end of the experiment, fish behavioral responses, clinical signs, survivability, growth, whole-body composition, intestinal digestive enzymes, serum biochemical parameters, hepatic antioxidative biomarkers, and transcription of stress and apoptosis genes were assessed. Results showed that the whole-body composition, intestinal α-amylase and protease enzymes, serum AST and blood urea levels, and hepatic GSH were not significantly different among groups (P > 0.05). The Tl-intoxicated fish group was off food, had darkened skin, showed restlessness and hyperexcitability, and high mortalities. FBW, WG, SGR and FI were significantly decreased alongside increase FCR in the Tl-exposed group. Tl exposure caused significant increases (P < 0.05) in intestinal lipase enzyme and serum indices such as ALT, creatinine, total cholesterol, triglycerides, glucose, and cortisol levels. Moreover, a significant decreases in hepatic CAT and SOD enzyme activities and significant increases in hepatic MDA contents were also noticed (P < 0.05). Furthermore, Tl exposure induced significant upregulation of hepatic HSP70 and apoptosis-related genes (p53 and caspase 3). Interestingly, dietary supplementation with ASP in ASPL-Tl and ASPH-Tl groups modulated the parameters mentioned above but still not reached the CONT values. Altogether, this study suggests that ASP could be beneficial in the modulation of sub-lethal Tl toxicity effects in Nile tilapia. Additionally, we can conclude that using natural feed supplements such as ASP in aquafeed might be necessary for maintaining the overall health performances of Nile tilapia.

Neurobehavioral, physiological and inflammatory impairments in response to bifenthrin intoxication in Oreochromis niloticus fish: Role of dietary supplementation with Petroselinum crispum essential oil.

This study was conceptualized in order to assess the 96-h LC50 of bifenthrin (BF) in O. niloticus and also to measure the biochemical, behavioral, and molecular responses of the fish suchronically exposed to a sub-lethal concentration of the insecticide. The role of Petroselinum crispum essential oil (PEO) supplementation in mitigating the resulted neurotoxic insult was also investigated. The acute toxicity study revealed that the 96-h LC50 of BF is 6.81 µg/L, and varying degrees of behavioral changes were recorded in a dose-dependent manner. The subchronic study revealed reduction of dissolved oxygen and increased ammonia in aquaria of BF-exposed fish. Clinical signs revealed high degree of discomfort and aggressiveness together with reductions in survival rate and body weight gain. The levels of monoamines in brain, and GABA and amino acids in serum were reduced, together with decreased activities of Na+/K+-ATPase and acetylcholine esterases (AchE). The activities of antioxidant enzymes were also diminshed in the brain while oxdative damage and DNA breaks were elevated. Myeloperoxidase (MPO) activity in serum increased with overexpression of the pro-inflammatory cytokines in the brain tissue. BF also upregulated the expression of brain-stress related genes HSP70, Caspase-3 and P53. Supplemention of PEO to BF markedly abrogated the toxic impacts of the insecticide, specially at the high level. These findings demonstrate neuroprotective, antioxidant, genoprotective, anti-inflammatory and antiapoptic effects of PEO in BF-intoxicated fish. Based on these mechanistic insights of PEO, we recommend its use as an invaluable supplement in the fish feed.

Nanostructured Lipid Carriers to Mediate Brain Delivery of Temazepam: Design and In Vivo Study.

The opposing effect of the blood-brain barrier against the delivery of most drugs warrants the need for an efficient brain targeted drug delivery system for the successful management of neurological disorders. Temazepam-loaded nanostructured lipid carriers (NLCs) have shown possibilities for enhancing bioavailability and brain targeting affinity after oral administration. This study aimed to investigate these properties for insomnia treatment. Temazepam-NLCs were prepared by the solvent injection method and optimized using a 42 full factorial design. The optimum formulation (NLC-1) consisted of; Compritol® 888 ATO (75 mg), oleic acid (25 mg), and Poloxamer® 407 (0.3 g), with an entrapment efficiency of 75.2 ± 0.1%. The average size, zeta potential, and polydispersity index were determined to be 306.6 ± 49.6 nm, -10.2 ± 0.3 mV, and 0.09 ± 0.10, respectively. Moreover, an in vitro release study showed that the optimized temazepam NLC-1 formulation had a sustained release profile. Scintigraphy images showed evident improvement in brain uptake for the oral 99mTc-temazepam NLC-1 formulation versus the 99mTc-temazepam suspension. Pharmacokinetic data revealed a significant increase in the relative bioavailability of 99mTc-temazepam NLC-1 formulation (292.7%), compared to that of oral 99mTc-temazepam suspension. Besides, the NLC formulation exhibited a distinct targeting affinity to rat brain. In conclusion, our results indicate that the developed temazepam NLC formulation can be considered as a potential nanocarrier for brain-mediated drug delivery in the out-patient management of insomnia.

Efficacy of some feed additives to attenuate the hepato-renal damage induced by aflatoxin B1 in rabbits.

The present trial was conducted to evaluate the beneficial role of some feed additives (potassium sorbate; Sor, hydrated sodium calcium almuniosilicate; Hsc and l-methionine; L-M) in attenuating the hepatic and renal toxicity of aflatoxin B1 (AFB1) in rabbits. A total number of 72 NZW growing rabbits (5 week-old) were divided into six experimental groups (four replicates with three rabbits each) as follows: control group, AFB1 group (supplemented with AFB1 0.3 mg/kg diet), AFB1 + Sor group (AFB1 0.3 mg/kg diet + Sor 2 g/kg diet), AFB1 + Hsc group (AFB1 0.3 mg/kg diet + Hsc 5 g/kg diet), AFB1 + L-M group (AFB1 0.3 mg/kg diet + L-M 8 g/kg diet) and AFB1 + Mix group (AFB1 0.3 mg/kg diet + 2 Sor + 5 Hsc + 8 L-M g/kg diet). Serum levels of total protein, albumin and globulin were significantly reduced by AF. AF increased the serum activity of aspartate aminotransferase (AST), alanine amino transferase (ALT) and alkaline phosphatase (ALP) enzymes. While, they were reduced in AF + Sor and AF + Mix groups compared with AF group. AF increased the level of cystatin C and Beta-2 microglobulin (BMG). All other supplements significantly reduced the level of cystatin C than AF; however, this reduction was more pronounced in AF-L-M group. AF + Sor, AF + L-M and AF + Mix equally reduced the BMG level than AF and AF + HSc, however, still higher than control. AF elevated the total cholesterol (TC) and LDL-cholesterol levels. A significant reduction in HDL cholesterol was seen in AF group. Additionally, AF induced pathological alterations in the liver and kidney of exposed rabbits on the other hands, the three additives separately or in mix attenuated the Af-induced alterations. In conclusion, the dietary supplementation of Sor, L-M, Hsc or their mixture was effective in ameliorating the negative effects of AFB1 on liver and kidney function and structure in rabbits with more better improvement obtained by Sor or L-M separately.

Dietary supplementation of potassium sorbate, hydrated sodium calcium almuniosilicate and methionine enhances growth, antioxidant status and immunity in growing rabbits exposed to aflatoxin B1 in the diet.

The present experiment was conducted to evaluate the effect of dietary supplementation with some feed additives (potassium sorbate; Sor, hydrated sodium calcium almuniosilicate; Hsc and L-methionine; L-M) against aflatoxin B1 (AF) toxicity in rabbits. A total of 72 growing rabbits (5-week-old) were distributed into six equal groups (4 replicates with 3 rabbits each). The experimental groups are as follows: control group, AF group (supplemented with AF 0.3 mg/kg diet), AF + Sor group (AF 0.3 mg/kg diet + Sor 2 g/kg diet), AF + Hsc group (AF 0.3 mg/kg diet + Hsc 5 g/kg diet), AF + L-M group (AF 0.3 mg/kg diet + L-M 8 g/kg diet) and AF + Mix group (AF 0.3 mg/kg diet + 2 Sor + 5 Hsc + 8 L-M g/kg diet). Live body weight and weight gain at 13 weeks of age were significantly reduced by AF. Feed intake at 13 weeks of age was decreased in AF, AF + Hsc and AF + Mix compared to the control. AF, AF + Hsc and AF + Mix showed the lowest total antioxidant capacity compared to the control. The highest level of reactive oxygen species and 8-Hydroxy-2-desoxyguanosine was observed in AF group. Using of other supplements with AF increased immunoglobulinM than AF alone. In conclusion, dietary supplementation of Sor, L-M, Hsc or their mixture was effective in reducing the adverse effects of AF on performance, antioxidant and immune status of rabbits with more better improvement obtained by Sor or L-M separately.

The role of some feed additives in fish fed on diets contaminated with cadmium.

The decline of cadmium pollution in fish farms is needed by any adequate method. The present study was designed to explore the effect of dietary cadmium contamination and its amelioration by using dietary clay, probiotic (Bactocell®), vitamin C, and vitamin E supplementation in Nile tilapia fish diet on growth rate, feed efficiency, blood components, and cadmium residues. Fish were separated into 15 groups, each group of fish was stocked into three aquaria and each contains 20 fishes. The fish of the first five groups were fed the basal diet, the second five groups were fed the basal diet contaminated with 25 mg cadmium/kg, and the third five groups were fed the same diet contaminated with 50 mg cadmium/kg. Within each dietary cadmium level, the first group was fed the diet without any supplementation, the second was fed the diet supplemented with natural clay (bentonite) at level 3%, the third group was fed the diet supplemented with 1 g Bactocell®/kg, the fourth group was fed the diet supplemented 50 mg vitamin E/kg, and the fifth group was fed the diet supplemented with 100 mg vitamin C/kg. Live body weight, daily body weight gain, and feed intake of Nile tilapia decreased significantly (P < 0.001) with increasing dietary cadmium level, while feed conversion was impaired. Fish group fed on diets contaminated with 50 mg cadmium/kg recorded the lowest live body weight and weight gain. Serum total protein and albumin concentration significantly (P < 0.001) decreased, while serum creatinine, AST, and ALT significantly (P < 0.001) increased with increasing cadmium level in fish diets. Blood hemoglobin and total erythrocyte (RBCs) significantly (P < 0.001 or 0.05) decreased with cadmium contamination in fish diets, while leukocytes were insignificantly affected. Body cadmium residues increased significantly (P < 0.001) by increasing cadmium level in fish diets. Live body weight, daily body weight gain, and feed intake of Nile tilapia increased significantly (P < 0.001) with feed additive supplementation in diets, also while feed conversion improved. Fish group fed on diets supplemented with probiotic Bactocell® or natural clay recorded higher body weight and gain rate than the other experimental groups. Serum total protein, blood hemoglobin, and total erythrocyte increased, while urea-N, creatinine, ALT, AST, and leukocytes decreased as affected with the feed additive supplementation. Feed additive supplementation in fish diets significantly (P < 0.001) decreased cadmium residues in fish bodies. Irrespective of dietary cadmium level, feed additive supplementation in fish diet improved the growth rate and decreased the concentrations of serum creatinine and ALT. The obtained results indicated that feed additive supplementation could modify the function of the kidney and liver in fish exposed to the cadmium toxicity.