Iraj Heydari

Purpose: To evaluate the effects of radioactive iodine (RAI) ablation after radiofrequency ablation (RFA) in patients with recurrent papillary thyroid carcinoma (PTC). Material and methods: We conducted a retrospective cohort study involving 60 patients with documented cervical lymph node (LN) recurrent PTC. All RFA procedures were performed using the “pulling-back, moving-shot” approach under local anaesthesia. LN volume reduction ratio (VRR), thyroglobulin, and complications were analysed 6 and 12 months after RFA. This study comprised two distinct groups of patients: one group that received a combination of RFA and RAI ablation, and another group that underwent RFA alone (30 cases in each group). Results: The mean age of patients was 39.8 ± 10.5 years, 68% of whom were women. VRR of LNs was significant at 6 months and 12 months after RFA (87.4% and 91.9%, respectively, p < 0.001). Serum thyroglobulin level decreased after 12 months (2.7 ± 5.9 to 0.6 ± 1.8, p = 0.021). Post-RFA complication was noted in one patient with transient hoarseness. Ten new recurrent LNs were reported in 9 patients (15%) during follow-up. No benefit was detected for the RAI treatment at the end of 12 months of follow-up in terms of structural or biochemical recurrence. Based on the non-randomised retrospective study design, this comparison is descriptive in nature and cannot be used to make any causal inference regarding the effectiveness of adjuvant RAI. Conclusions: RFA has been shown to be effective in achieving volume reduction with a high success rate of 97% and with minimal complications. There was no additional benefit of adjuvant RAI. However, this result cannot be used to make any inference regarding the effectiveness of RAI due to confounding by indication. A prospective randomised trial is needed.

Background: Low grade inflammation and oxidative stress are the key factors in the pathogenesis and development of diabetes and its complications. Coenzyme Q10 (CoQ10) is known as an antioxidant and has a vital role in generation of cellular energy providing. This study was undertaken to evaluate the effects of CoQ10 supplementation on lipid profiles and glycemic controls in patients with diabetes. Methods: Fifty patients with diabetes were randomly allocated into two groups to receive either 150 mg CoQ10 or placebo daily for 12 weeks. Before and after supplementation, fasting venous blood samples were collected and lipid profiles containing triglyceride, total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) and glycemic indices comprising of fasting plasma glucose (FPG), insulin and hemoglobin A₁C (HbA₁C) were measured. Insulin resistance was calculated using HOMA-IR index. Results: Forty patients completed the study. After intervention FPG and HbA₁C were significantly lower in the CoQ10 group compared to the placebo group, but there were no significant differences in serum insulin and HOMA-IR between the two groups. Although total cholesterol did not change in the Q10 group after supplementation, triglyceride and HDL-C significantly decreased and LDL-C significantly increased in the CoQ10 group. Conclusion: The present study showed that treatment with Q10 may improve glycemic control with no favorable effects on lipid profiles in type 2 patients with diabetes. Trial registration: IRCT registry number: IRCT138806102394N1