Treatment of Thyroid Disorders

The formation of l from 1 had been postulated by Vetter [8a]. From the above information we can make the following conclusions (a) l" (atom-free radical) can be produced electrochemically, (b) l" does react with pyridine and may react with similar compounds and (c) recombination of l" may be slow in solution phase. Molecular iodine (di-iodine) the radio-isotope, is being used in the treatment of thyroid disorder. One can ask the question is there any biologically beneficial or toxic effect of iodine atom. There has been no study [8b]. 

Poly-a-L-glutamic acid derivatives prepared by Piccariello et al. (4) were functionalized with iV-octanoyl-L-triiododiyronine and used in the treatment of thyroid disorders. 

The thyroid hormones, exemplified by thyroxine, provide another case where NMR relaxation time measurements give an insight into internal flexibility, and perhaps mode of action, of pharmaceutically important molecules. Synthetic thyroxine, 5, is widely used for the treatment of thyroid disorders, and indeed was the second most widely prescribed drug in the United States in 1998. 

Medical science also uses small traces of safe radioactive materials to track the passage of materials around a body or plant. Radio-thallium-201 is used to assess the damage to heart muscles after a person has had a heart attack. Radioactive iodine-131 is used in the treatment of thyroid disorders. 

Assays of thyroid function Advances in thyroid function tests (TFTs), including the development of sensitive assays for TSH and the use of analog assays that provide a reasonable estimate of the free level, have markedly improved the diagnosis and treatment of thyroid disorders. These assays nonetheless can be misleading, as the TSH level can remain low for weeks to months after a hyperthyroid patient is restored to a euthyroid state and the analog assays of free T can provide misleading results in certain settings such as critical iUness. 

The study of medicinal chemistry has improved the treatment of thyroid disorders by reducing variability in plasma concentrations of T3 and T4 and by increasing the reliability of available monitoring methods. Accurate monitoring and therapy adjustments have resulted in fewer complications and increased quality of life among the millions of patients with thyroid disorders. 

Kovala-Demertzi et al. used the complexing ability effect of 1-methyl-imida-zoline-2(3//)-thione (Hmimt) and imidazoline-2(l,3//)-thione (Himt) with several organotin compounds. Hmimt is used in the treatment of thyroid disorders. ... 

In the treatment of hyperthyroidism the dose of 131I is usually a few millicuries and is either roughly estimated or calculated according to the size of the thyroid gland, the uptake of a tracer dose of iodine, and the type of thyroid disorder (diffuse or nodular), with doses ranging from 80 to 150 microCi (3.0-5.5 MBq) per gram of thyroid tissue (3,4). 

In addition to the underlying disease, there are many potential susceptibility factors (499,519). There is as yet no definitive evidence that age, sex, dose, and duration of treatment play an important role in the development of thyroid disorders. However, patients with previous thyroid abnormalities are predisposed to develop more severe thyroid disease (SEDA-20, 328). The incidence of thyroid disease was not different between natural and recombinant interferon alfa. Although this should be taken into account, a previous familial or personal history of thyroid disease was generally not considered a major risk factor. Finally, only pre-treatment positivity or the development of thyroid antibodies during treatment seem to be strongly associated with the occurrence of thyroid dysfunction. 

The production of thyroid disorders by lithium is common and requires constant concern throughout the treatment. Lithium-induced hypothyroidism can produce depression and other mental dysfunction, greatly confusing and complicating the patient s clinical picture. 

In medical installations, the use of radioactive isotopes for diagnosis and therapy has significantly increased in the past years. Nonencapsulated radioactive elements are used for different purposes such as in diagnosis by tracers, treatment of thyroid or blood disorder, and in medical research. These activities produce some solid radioactive wastes like cotton, rubber gloves, syringes, etc., as well as liquid wastes, mainly scintillation liquids. Another type of waste is the encapsulated sources that are used for cancer treatment these elements must be changed when their activity decays below a certain level. 

In a prospective study, the overall incidence of biochemical thyroid disorders was 12% in 254 patients with chronic hepatitis C randomized to receive ribavirin plus high-dose interferon alfa (6 MU/day for 4 weeks then 9 MU/week for 22 weeks) or conventional treatment (9 MU/week for 26 weeks) (165). There was no difference in the incidence or the time to occurrence of thyroid disorders between the groups. Of the 30 affected patients, 11 (37%) had positive thyroid peroxidase autoantibodies (compared with 1% of patients without thjroid dysfunction), nine developed symptomatic thjroid dysfunction, and only three had to discontinue treatment. There was no correlation between the viral response and the occurrence of thyroid disorders, and only female sex and Asian origin were independent predictors of thyroid disorders. 

Other possibilities for identification (ID) of patients with thyroid disorders are searching in different records or databases, such as records of diagnoses of discharge from hospitals, prescriptions of thyroid medicaments (antithyroid drugs and levothyroxine), and records of treatments for thyroid disorders including thyroid surgery and radioiodine treatments. Finally, diagnosis of overt thyroid dysfunction is based on a biochemical thyroid function test, and laboratory databases with results of analyses of thyrotrophin (TSH) and thyroid hormones in a population cohort, and records of serum TSH in newborns may be used to identify new patients (Kempers et al., 2006). 

Radioiodine plays an important role in the diagnosis and treatment of various thyroid disorders. Treatment of thyroid carcinoma and hyperthyroidism with I-pharmaceuticals has been practiced for years, but other isotopes, i.e., I, >231, 1241 and are also produced and used in various medical apphcations. Radioiodine concentrated by the thyroid in large amounts can cause cell death, primarily because of 3ils beta radiation. Large doses of 3il are, therefore, given to treat patients with hyperthyroidism. In contrast, low-dose exposure damage does not kill thyroid cells, but can induce radiation damage and mutations, which can result in thyroid cancer. 

During the training of medical doctors and health staff the emphasis is usually on a clinical approach to diagnosis and treatment of thyroid abnormalities. Their training rarely covers the public health aspects of iodine deficiency and its disorders, such as brain damage and a loss of intelligence quotient (IQ) in children, neither does it cover the prevention and control of IDD programs on a population... 

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