Prevalence of hyperthyroidism after exposure during childhood or adolescence to radioiodines from the chornobyl nuclear accident: dose-response results from the Ukrainian-American Cohort Study.

Relatively few data are available on the prevalence of hyperthyroidism (TSH concentrations of <0.3 mIU/liter, with normal or elevated concentrations of free T4) in individuals exposed to radioiodines at low levels. The accident at the Chornobyl (Chernobyl) nuclear plant in Ukraine on April 26, 1986 exposed large numbers of residents to radioactive fallout, principally to iodine-131 ((131)I) (mean and median doses  =  0.6 Gy and 0.2 Gy). We investigated the relationship between (131)I and prevalent hyperthyroidism among 11,853 individuals exposed as children or adolescents in Ukraine who underwent an in-depth, standardized thyroid gland screening examination 12-14 years later. Radioactivity measurements taken shortly after the accident were available for all subjects and were used to estimate individual thyroid doses. We identified 76 cases of hyperthyroidism (11 overt, 65 subclinical). Using logistic regression, we tested a variety of continuous risk models and conducted categorical analyses for all subjects combined and for females (53 cases, n  =  5,767) and males (23 cases, n  =  6,086) separately but found no convincing evidence of a dose-response relationship between (131)I and hyperthyroidism. There was some suggestion of elevated risk among females in an analysis based on a dichotomous dose model with a threshold of 0.5 Gy chosen empirically (OR  =  1.86, P  =  0.06), but the statistical significance level was reduced (P  =  0.13) in a formal analysis with an estimated threshold. In summary, after a thorough exploration of the data, we found no statistically significant dose-response relationship between individual (131)I thyroid doses and prevalent hyperthyroidism.

Autoimmune thyroiditis and exposure to iodine 131 in the Ukrainian cohort study of thyroid cancer and other thyroid diseases after the Chornobyl accident: results from the first screening cycle (1998-2000).

CONTEXT: Due to the Chornobyl accident, millions were exposed to radioactive isotopes of iodine and some received appreciable iodine 131 (131I) doses. A subsequent increase in thyroid cancer has been largely attributed to this exposure, but evidence concerning autoimmune thyroiditis (AIT) remains inconclusive. OBJECTIVE: The objective of the study was to quantify risk of AIT after 131I exposure. DESIGN/SETTING/PARTICIPANTS: Baseline data were collected from the first screening cycle (1998-2000) of a large cohort of radiation-exposed individuals (n = 12,240), residents of contaminated, iodine-deficient territories of Ukraine. Study individuals were under the age of 18 yr on April 26, 1986, and had thyroid radioactivity measurements made shortly after the accident. OUTCOMES: AIT was defined a priori based on various combinations of elevated antibodies to thyroid peroxidase (ATPO), TSH, and clinical findings; elevated ATPO were considered to be an indicator of thyroid autoimmunity. RESULTS: No significant association was found between 131I thyroid dose estimates and AIT, but prevalence of elevated ATPO demonstrated a modest, significant association with 131I that was well described by several concave models. This relationship was apparent in individuals with moderately elevated ATPO and euthyroid, thyroid disease-free individuals. CONCLUSIONS: Twelve to 14 yr after the Chornobyl accident, no radiation-related increase in prevalence of AIT was found in a large cohort study, the first in which 131I thyroid doses were estimated using individual radioactivity measurements. However, a dose-response relationship with ATPO prevalence raises the possibility that clinically important changes may occur over time. Thus, further follow-up and analysis of prospective data in this cohort are necessary.

[Nifedipine in the treatment of arterial hypertension in patients with the neuroendocrine-metabolic form of the hypothalamic syndrome]. / Nifedipin v lechenii arterial'noi gipertenzii u bol'nykh s neiroéndokrinno-obmennoi formoi gipotalamicheskogo sindroma.

The authors submit results of treatment of 30 patients presenting with neuroendocrine-metabolic form of hypothalamic syndrome with a 3-months course administration of nifedipine on a 30-mg daily schedule. Before the treatment, the patients had persistent arterial hypertension and abnormal values for central hemodynamics presenting as hypokinetic syndrome. After the treatment with corinfar, the patients fared significantly better, with the arterial pressure and index of the general peripheral vascular resistance getting down. Values for minute volume, stroke volume, cardiac index tended towards normalization.

[Atrial natriuretic hormone in certain forms of arterial hypertension of endocrine origin]. / Predserdnyi natriiureticheskii gormon pri nekotorykh formakh arterial'noi gipertenzii éndokrinnogo geneza.

Atrial natriuretic peptide is shown to be a hormone having a certain part to play in the regulation of arterial blood pressure and water-salt metabolism. Results of study on the plasma content of the hormone in patients with various forms of arterial hypertension of endocrine genesis are presented. Differentially directed changes have been revealed in concentrations of immunoreactive atrial natriuretic peptide. Elucidation of the role of these in the pathogenesis of the pathology under consideration warrants further study in a comparative evaluation wtih the parameters of cardiohaemodynamics and water-salt metabolism.

[Peripheral circulation regulation in patients with the neuroendocrine metabolic form of hypothalamic syndrome]. / Reguliatsiia perifericheskogo krovoobrashcheniia u bol'nykh s neiroéndokrinno-obmennoi formoi gipotalamicheskogo sindroma.

Peripheral circulation and regulating hormonal (renin-angiotensin-aldosterone system) and electrolytic (plasma sodium and potassium) factors were studied in 102 patients with the hypothalamic syndrome neuroendocrine metabolic form administered pathogenetic therapy with antiserotonin and dopaminergic drugs as well as routine therapy. Blood plasma sodium vasopressin and aldosterone levels were found increased, arterial vessel reactivity in the forearm reduced, and venous circulation disordered in these patients. Routine therapy failed to normalize electrolytes and hormonal parameters and was conducive to a still more marked reduction of arterial vessel reactivity. Peritol therapy resulted in a reduction of vasopressin concentration and normalization of blood plasma sodium and aldosterone, as well as in improvement of the myogenic mechanisms of vascular tone regulation and normalization of venous circulation parameters. A course of parlodel therapy lead to normalization of blood plasma levels of vasopressin, aldosterone, and sodium but no changes in the regional vessels were observed.

[Atrial natriuretic factor in endocrine pathology]. / Predserdnyi natriiureticheskii faktor pri éndokrinnoi patologii.

The content of basal immunoreactive atrial natriuretic hormone (ANH) in the venous blood plasma was studied in patients with various types of endocrine hypertension (Conn's syndrome, pheochromocytoma, neuroendocrine form of hypothalamic syndrome, diabetes mellitus) and diffuse toxic goiter. Increase of the ANH level was revealed in patients with primary aldosteronism, diabetes mellitus and hypertension, as well as with decompensated thyrotoxicosis and pronounced cardiac changes. In patients with neuroendocrine pattern of the hypothalamic syndrome the ANH level remained unchanged, in those with pheochromocytoma it decreased.

[Use of dibunol in treating radiation injuries to the skin and mucosa]. / Primenenie dibunola pri lechenii luchevykh povrezhdenii kozhi i slizistykh obolochek.

The authors present the results of the use of dibunol in the form of liniment (1-10%) for the treatment of radiation cystitis and rectitis resulting from radiation therapy of small pelvic tumors, epidermitis and epithelitis that develop in the course of treatment of skin and lower lip tumors. A high efficacy of the drug in the therapy of radiation injury has been shown in 212 patients.