Pharmacological protection of the thyroid gland against radiation damage from radioactive iodine labeled compounds in children: a systematic review

Purpose: There is currently no consensus on which protective strategy is most effective to prevent I-131 uptake in the thyroid during medical interventions in children. We aimed to collect the best available evidence to determine which pharmacological intervention is most effective in protecting the thyroid gland from damage by radioactive iodine (RAI). Methods: Literature searches were performed using PubMed, Embase, OLDMEDLINE, and the Cochrane Central Register of Controlled Trials. Only original studies were included (1950–2022). Studies comparing pharmacological prevention of the thyroid against RAI uptake or occurrence of hypothyroidism, thyroid nodule or thyroid cancer were included. Included studies were graded according to the Grading of Recommendations Assessment, Development and Evaluation considerations. Pharmacological interventions were compared for effectiveness on reduction of thyroidal intake or relevant clinical thyroidal outcomes. Results: Forty studies were included. Quality of included studies was low and many different outcome variables were used, making meta-analysis impossible. In 81% of studies, the pharmacological intervention could not prevent RAI uptake or thyroid damage. The administration of potassium iodide (KI) 1 h before exposure to RAI seemed most effective to reduce thyroidal uptake, however, hypothyroidism was reported in up to 64% as well as several cases of thyroid carcinoma. The combination of KI, thyroxine and thiamazole reduced RAI uptake and occurrence of hypothyroidism; yet, after follow-up of 9 years, still 50% of patients developed hypothyroidism. KI with potassium perchlorate showed hypothyroidism to occur in up to 12% of patients after short follow-up time. Conclusions: The lack of well-designed studies impairs making strong recommendations on the optimal way to prevent thyroid damage when using radioactive coupled ligands for medical interventions. To improve the protection of the thyroid against radiation damage by I-131, well-designed randomized clinical trials with sufficient follow-up time, comparing new protective strategies’ effects on valid and well-defined thyroid outcomes are needed

Toddlers' preference for prosocial versus antisocial agents: No associations with empathy or attachment security

Research has indicated that the majority of infants and toddlers prefer prosocial to antisocial agents, but little research has examined interindividual differences in children's preference. This study examined whether 24-month-olds' (n = 107) sociomoral preference was associated with attachment security or empathy, assessed with the Attachment Q-Sort and the Empathy Questionnaire. Toddlers were presented with a puppet play, in which a protagonist tried to open a box and was helped by a prosocial agent and hindered by an antisocial agent. Then, toddlers were asked to pick up either the prosocial or the antisocial agent (manual choice), as a measure of their sociomoral preference. Of the 107 toddlers included in this study, 60.7% chose the prosocial over the antisocial agent. Neither empathy nor parent-child attachment was associated with children's preference. Our findings indicate a slight overall preference for the prosocial agent, but with notable interindividual differences not explained by empathy or attachment

Familial Aggregation of Cognitive Biases for Children with Anxiety Disorders

Previous studies described a relation between anxiety-related cognitive biases in normally developing children and parents. The current study examined the familial aggregation of cognitive biases in children with anxiety disorders (N = 55) and their parents, wit

Combination of a six microRNA expression profile with four clinicopathological factors for response prediction of systemic treatment in patients with advanced colorectal cancer

Background First line chemotherapy is effective in 75 to 80% of patients with metastatic colorectal cancer (mCRC). We studied whether microRNA (miR) expression profiles can predict treatment outcome for first line fluoropyrimidine containing systemic therapy in patients with mCRC. Methods MiR expression levels were determined by next generation sequencing from snap frozen tumor samples of 88 patients with mCRC. Predictive miRs were selected with penalized logistic regression and posterior forward selection. The prediction co-efficients of the miRs were re-estimated and validated by real-time quantitative PCR in an independent cohort of 81 patients with mCRC. Results Expression levels of miR-17-5p, miR-20a-5p, miR-30a-5p, miR-92a-3p, miR-92b-3p and miR-98-5p in combination with age, tumor differentiation, adjuvant therapy and type of systemic treatment, were predictive for clinical benefit in the training cohort with an AUC of 0.78. In the validation cohort the addition of the six miR signature to the four clinicopathological factors demonstrated a significant increased AUC for predicting treatment response versus those with stable disease (SD) from 0.79 to 0.90. The increase for predicting treatment response versus progressive disease (PD) and for patients with SD versus those with PD was not significant. in the validation cohort. MiR-17-5p, miR-20a-5p and miR-92a-3p were significantly upregulated in patients with treatment response in both the training and validation cohorts. Conclusion A six miR exp

Ik sta graag op het podium: Het KIDARTS 2.0 meetinstrument over het welzijn van kunstkinderen

Om deze meetmethode te kunnen ontwikkelen is allereerst een verkennend onderzoek gedaan naar factoren die een rol spelen bij het welzijn van kunstkinderen. Hiervoor zijn de kinderen zelf, hun ouders en diverse andere stakeholders geraadpleegd. Vervolgens is er een meetmethode ontwikkeld, die, in de vorm van een digitale vragenlijst, als pilot is getest onder 61 kinderen en hun ouders. De digitale vragenlijst (KIDARTS1.0) bleek binnen de pilottest goed ingevuld te kunnen worden door de kinderen en hun ouders en bleek een goed inzicht te kunnen geven in de belasting van de werkzaamheden en het welzijn van de kinderen verdeeld over de diverse soorten producties. Over het algemeen werd teruggevonden dat bij producties die het meeste tijd en weekenddagen hadden gekost, de kinderen en ouders positiever waren over de begeleiding (mogelijk doordat er meer tijd voor goede begeleiding was) en de kinderen vaker uitgerust waren na een productiedag. De werving voor het invullen van de vragenlijst door kinderen en ouders bleek lastig omdat dit niet via de producentenverenigingen over inspectie kon. De meeste ouders en kinderen vonden het geen probleem om de vragen in de vragenlijst te beantwoorden en vonden het goed dat hiernaar gevraagd werd. De vragenlijsten uit de pilot (KIDARTS1.0) worden in tabel 4a en 4b aangepast naar de uiteindelijke vragenlijst (KIDARTS2.0). Aan het eind van deze rapportage worden enkele conclusies getrokken uit dit onderzoek en enkele aanbevelingen gegeven voor toekomstig gebruik van KIDARTS2.0

Embolisation for caecal bleeding in a child with typhlitis

A 16-year-old girl being treated for a relapse of promyelocytic leukaemia developed typhlitis of the caecum and ascending colon related to Klebsiella septicaemia during the neutropenic phase, 2 weeks after the start of induction treatment with chemotherapy. After 10 days of treatment with parenteral feeding and antibiotics, massive rectal blood loss occurred, causing haemodynamic instability. Contrast-enhanced abdominal CT showed contrast extravasation in the caecal lumen. This life-threatening situation prompted visceral angiography, which confirmed a contrast blush in the caecum. Subsequent embolisation resulted in haemodynamic stabilit