Effects of Photobiomodulation With Two Wavelengths of 630 and 810 nm on Diabetic Neuropathy

Introduction: Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes patients. Among different therapeutic approaches for treating DPN, low-level laser therapy (LLLT) or photobiomodulation (PBM) is a new promising non-invasive technique. This study aims to evaluate the effect of visible and infra-red LLLT on DPN. Methods: Sixty DPN patients enrolled in a randomized-controlled study. The patients were randomly divided into the same population of control and laser groups. The patients in the laser group received LLLT with two wavelengths of 630 and 819 nm and conventional therapy, and those in the control group received conventional therapy alone. Irradiation of the patients lasted 15 minutes per session, and it was performed over the surface of each foot three times a week for 12 sessions. The patients were evaluated at baseline and at the end of the study with the Michigan Neuropathy Screening Instrument (MNSI) and microfilament test. Results: Patients' sensation in the right foot in the monofilament test had increased from 22 (84.6%) to 26 (86.7%) (P=0.000), and in the left foot it had increased from 20 (80%) to 25 (86.2%) (P=0.001). The mean and standard deviation of the scores of section A of the Michigan questionnaire showed a statistically significant difference between the two groups (P<0.05), but the B part scores of the Michigan test did not show a significant difference. Conclusion: This study showed that the visible and infra-red LLLT significantly improved the symptoms of diabetic neuropathy without any side effects.

Photobiomodulation therapy reverses spermatogenesis arrest in hyperthermia-induced azoospermia mouse model

Testicular heat stress leads to impairment of spermatogenesis in mammals. Involved mechanism in this vulnerability to heat-induced injury remains unclear, and research is being conducted to find an approach to reverse spermatogenesis arrest caused by hyperthermia. Recently, different studies have utilized photobiomodulation therapy (PBMT) therapy for the improvement of sperm criteria and fertility. This study aimed at evaluating the effect of PBMT on the improvement of spermatogenesis in mouse models of hyperthermia-induced azoospermia. A total of 32 male NMRI mice were equally divided into four groups consisting of control, hyperthermia, hyperthermia + Laser 0.03 J/cm2, and hyperthermia + Laser 0.2 J/cm2. To induce scrotal hyperthermia, mice were anesthetized and placed in a hot water bath at 43 °C for 20 min for 5 weeks. Then, PBMT was operated for 21 days using 0.03 J/cm2 and 0.2 J/cm2 laser energy densities in the Laser 0.03 and Laser 0.2 groups, respectively. Results revealed that PBMT with lower intensity (0.03 J/cm2) increased succinate dehydrogenase (SDH) activity and glutathione (GSH)/oxidized glutathione (GSSG) ratio in hyperthermia-induced azoospermia mice. At the same time, low-level PBMT reduced reactive oxygen species (ROS), mitochondrial membrane potential, and lipid peroxidation levels in the azoospermia model. These alterations accompanied the restoration of spermatogenesis manifested by the elevated number of testicular cells, increased volume and length of seminiferous tubules, and production of mature spermatozoa. After conducting experiments and analyzing the results, it has been revealed that the use of PBMT at a dosage of 0.03 J/cm2 has shown remarkable healing effects in the heat-induced azoospermia mouse model.

Wavelength of the Laser in Low Level Laser Therapy

The Article Abstract is not available.

Effect of low-level laser therapy (LLLT) on cognitive impairment among patients with chronic schizophrenia: a double-blind randomized placebo-controlled clinical trial

Low-level laser therapy (LLLT) is a noninvasive technique used in different medical fields. It has been applied in different medical areas such as wound healing, traumatic brain injuries, neurological disorders, cognitive disorders, Alzheimer's disease, pain, and arthritis, with different results. We studied the effectiveness of LLLT on cognitive impairment in patients with chronic schizophrenia. A randomized controlled double-blind clinical trial was performed in a men's chronic treatment center, in Razi Psychiatric Hospital, in Tehran, Iran. We screened the cognitive impairment by Mini-Mental State Examination (MMSE). Positive And Negative Syndrome Scale (PANSS) was also used to assess the patients' positive and negative symptoms. Seventeen consenting patients were randomly allocated to the treatment arm, and 15 to the sham treatment control arm. The mean age of the control and treated patients was 49.47 ± 6.99 and 50.24 ± 7.69, respectively. No significant difference in PANSS and MMSE test scores was detected in both groups after the 6th session and after 2 months of follow-up after laser therapy. The positive and negative scales and agitation and excitement levels did not change significantly in either group. Nevertheless, the depression/anxiety subscale in the PANSS test showed a significant reduction after 6 sessions but did not persist after 2 months. No improvement in cognitive impairment or the positive and negative symptoms was detected after LLLT in patients with chronic schizophrenia. Trial registration: IRCT 20210520051349N1.

Photobiomodulation therapy improved functional recovery and overexpression of interleukins-10 after contusion spinal cord injury in rats

Following severe Spinal Cord Injury (SCI), regeneration is inadequate, and functional recovery is incomplete. The occurrence of oxidative stress and the spread of inflammation play a crucial role in the failure to regenerate the injury site. In this way, we explored the neuroprotective effects of PhotoBioModulation (PBM), as the main factor in controlling these two destructive factors, on SCI. fifty-four female adult Wistar rats divided into three groups: sham group (just eliminate vertebra lamina, n = 18), SCI group (n = 18), and SCI-PBM group which exposed to PBM (150 MW, 50 min/day, 14 days, n = 18). After SCI induction at the endpoint of the study (the end of 8 week), we took tissue samples from the spinal cord for evaluating the biochemical profiles that include Catalase (CAT), Malondialdehyde (MDA), Superoxide Dismutase (SOD), Glutathione Peroxidase (GSH-PX) levels, immunohistochemistry for Caspase-3, gene expressions of Interleukin-1β (IL-1β), Tumor Necrosis Factor-alpha (TNF-α), and Interleukin (IL-10). Also, stereological assessments evaluated the spinal cord, central cavity volumes, and numerical density of the glial and neural cells in the traumatic area. The open-field test, rotarod test, Narrow Beam Test (NBT), Electromyography recording (EMG) test and the Basso-Beattie-Bresnehan (BBB) evaluated the neurological functions. Our results showed that the stereological parameters, biochemical profiles (except MDA), and neurological functions were markedly greater in the SCI-PBM group in comparison with SCI group. The transcript for the IL-10 gene was seriously upregulated in the SCI-PBM group compared to the SCI group. This is while gene expression of TNF-α and IL-1β, also density of apoptosis cells in Caspase-3 evaluation decreased significantly more in the SCI-PBM group compared to the SCI group. Overall, using PBM treatment immediately after SCI has neuroprotective effects by controlling oxidative stress and inflammation and preventing the spread of damage.

Does Combined Low-Level Laser and Light-Emitting Diode Light Irradiation Reduce Pain, Swelling, and Trismus After Surgical Extraction of Mandibular Third Molars? A Randomized Double-Blinded Crossover Study

PURPOSE

Complications after extraction of mandibular third molars, including pain, swelling, and trismus, are common problematic phenomena for both patients and surgeons. The main objective of the present study was to evaluate the therapeutic effect of combined low-level laser (LLL) and light-emitting diode (LED) irradiation on the recovery rate of such complications.

PATIENTS AND METHODS

The authors implemented a prospective randomized, double-blind crossover design. Forty participants (80 teeth) were enrolled, each with bilateral and symmetrical impacted lower third molars. Participants had lower third molars extracted at 2 separate visits. Participants were randomized to receive LLL plus LED or placebo at the initial surgical procedure. Participants acted as their control during the second surgical procedure. The primary predictor variable was LLL plus LED. The primary outcome variable was pain measured at postoperative days 3 and 7. Secondary outcome variables were swelling and trismus. The Mann-Whitney U, Wilcoxon, and Friedman tests were used for statistical analysis with a P < .05 considered significant.

RESULTS

The sample size of each group was 40 (male to female ratio of 1:1, mean age 24.8 ± 3.9). Preoperative scores of all scales were lower for both groups compared with days 3 and 7 (P < .0001). Postoperative pain levels on days 3 and 7 were significantly less in the intervention group (P = .03 and P = .01, respectively). Compared with the control group, the postoperative trismus level of the intervention group was significantly less on day 3 (P = .006). However, the difference on day 7 was not significant. Postoperative swelling levels on days 3 and 7 were significantly less in the intervention group (P < .0001).

CONCLUSIONS

Combined LLL plus LED irradiation could be an effective therapy to decrease postoperative pain and swelling after impacted third molar extractions.

Effectiveness of Extremely Low Frequency Electromagnetic Field and Pulsed Low-Level Laser Therapy in Acute Stroke Treatment

Introduction: Stroke is one of the most devastating neurologic conditions in the world. Despite all the efforts that have been made for effective treatment, the prevalence of this medical condition is still high. One of the new methods in the treatment of patients is the use of low power laser and pulsed magnetic fields. The previous studies investigated the effectiveness of these methods individually. However, the present study aimed to investigate their effectiveness in combination. Methods: We divided the patients into control (n=26) and experimental (n=26) groups. The primary variables included the Mini-Mental State Examination (MMSE) and the National Institute of Health Stroke Scale (NIHSS). The experimental group received extremely low-frequency electromagnetic field (EMF-ELF) treatment with 1 mT power and laser in rejection with a wavelength of 840 nm for 5 days and 45 min/d. Results: The variable measured during this study, in addition to comparing the results of the intervention between the control and experimental groups, showed a significant difference in all indicators before and after the intervention. The mean and standard deviations of the modified Rankin scale (mRS), functional status (Barthel’s index), and cognitive status (MMSE) (P<0.001) were signed between 2 groups. Conclusion: Laser and magnetic field combination can be effective in the treatment of stroke. Further studies are recommended to ensure a better comparison.

Can Low-Level Laser and Light-Emitting Diode Enhance the Stability of Dental Implants?

Purpose

Stability of dental implants is an important factor for evaluation of osseointegration. The aim of this study was to evaluate the effect of combined use of low-level laser (LLL) and light-emitting diode (LED) therapy on the stability of dental implants during the healing phase.

Materials and Methods

This was a randomized clinical trial. Patients were assigned to two groups: In group 1, patients received LLL and LED 20 min/day for 10 days after implant insertion. Patients in group 2 (controls) did not undergo LLL and LED. The implant stability quotient (ISQ) was measured at 0 (time 0), 10 (time 1), 21 (time 2), 42 (time 3) and 63 days (time 4) after implant placement. Independent t test was used to compare the ISQs between the two groups.

Results

Fifty-eight patients were studied in two groups (n = 28). The mean ISQ did not differ immediately after insertion (P > 0.05). The mean ISQ differed significantly between the two groups on days 10, 21, 42 and 63 (P < 0.05). Results demonstrated an increase in the amount of ISQ in group 1 (intervention) at times 1, 2, 3 and 4. In the control group, the amount of ISQ decreased on days 10 and 21 following implant insertion, but increased afterward on days 42 and 63.

Conclusion

The results of this study showed that simultaneous use of LLL and LED increased the stability of the implants after 9 weeks of follow-up.

The effects of electromagnetic fields on cultured human retinal pigment epithelial cells

A great deal of evidence has confirmed that electromagnetic fields (EMFs) can affect the central nervous system. In this study, cultured neonatal human retinal pigment epithelial (hRPE) cells were exposed to pulsed EMF of 1 mT intensity and 50 Hz frequency 8 h daily for 3 days. In addition to cell proliferation and cell death assays, immunocytochemistry for RPE65, PAX6, nestin, and cytokeratin 8/18 proteins were performed. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) was performed for NES, PAX6, RPE65, and ACTA2 gene expression. Exposed hRPE cells did not demonstrate significant change in terms of cytomorphology, cell proliferation, or cell death. Protein expression of PAX6 was decreased in treated cells compared to controls and remained unchanged for RPE65, cytokeratin 8/18, and nestin. Gene expressions of NES, RPE65, and PAX6 were decreased in treated cells as compared to controls. Gene expression of ACTA2 did not significantly change. In conclusion, viability of cultivated neonatal hRPE cells did not change after short exposure to a safe dose of pulsed EMF albeit that both gene and protein expressions of retinal progenitor cell markers were reduced. Whether longer exposure durations that are being constantly produced by widely-used electronic devices may induce significant changes in these cells, needs further investigation. Bioelectromagnetics. 39:585-594, 2018. © 2018 Wiley Periodicals, Inc.

Effect of pulsed electromagnetic field on mandibular fracture healing: A randomized control trial, (RCT)

INTRODUCTION

Currently, the pulsed electromagnetic field (PEMF) method is utilized for the treatment of nonunion long bone fractures. Considering the established effect of the PEMF on the acceleration of the bone healing process, we conducted this study to evaluate the effect of PEMF on the healing process in mandibular bone fractures.

MATERIAL AND METHODS

This research was a randomized control trial (RCT) study. The sample consisted of patients with a mandibular fracture who were hospitalized in order to receive closed reduction treatment. The participants were randomly selected and then sequentially divided into two groups of 16 participants each (controls = 16, cases = 16). The patients in the control group received conventional therapy without any extra treatment, while the patients in the case group received PEMF therapy in addition to conventional therapy. For the PEMF therapy, patients in the case group received immediate post-surgery PEMF therapy for 6 h. Next, they received 3 h of exposure for the next 6 d, and finally, the same process was repeated for 1.5 h for post-surgery days 8-13. The maxillomandibular fixation (MMF) device was removed at post-surgery week 4. The patients in the control group, however, did not receive any extra treatment. The efficiency of the treatment modalities was evaluated clinically and radiographically. For the radiographical assessment, we employed a direct digital panoramic machine to calculate the computerized density of the bone, and those measurements were used for comparison of the results between the control group and the study patients.

RESULTS

There was no significant difference in the mean bone density values between the two groups (P > 0.05). However, the percentage of changes in bone density of the two groups revealed that the case group had insignificant decreases at post-surgery day 14 and a significant increase at post-surgery day 28 compared with the control group (P < 0.05). After releasing the MMF, a bimanual mobility test of the fractured segments showed the stability of the segments in all patients. In the case group, the mouth opening was significantly more stable than that of the control group (P < 0.05).

CONCLUSION

PEMF therapy postoperatively leads to increased bone density, faster recovery, increased formation of new bone, a further opening of the mouth, and decreased pain.

Factors That Impact Evaluation of Left Ventricular Systolic Parameters in Myocardial Perfusion Gated SPECT with 16 Frame and 8 Frame Acquisition Models

Objective:

Evaluating the effects of heart cavity volume, presence and absence of perfusion defect, gender and type of study (stress and rest) on the difference of systolic parameters of myocardial perfusion scan in 16 and 8 framing gated SPECT imaging.

Methods:

Cardiac gated SPECT in both 16 and 8 framing simultaneously and both stress and rest phases at one-day protocol was performed for 50 patients. Data have been reconstructed by filter back projection (FBP) method and left ventricular (LV) systolic parameters were calculated by using QGS software. The effect of some factors such as LV cavity volume, presence and absence of perfusion defect, gender and type of study on data difference between 8 and 16 frames were evaluated.

Results:

The differences in ejection fraction (EF), end-diastolic volume (EDV) and end-systolic volume (ESV) in both stress and rest were statistically significant. Difference in both framing was more in stress for EF and ESV, and was more in rest for EDV. Study type had a significant effect on differences in systolic parameters while gender had a significant effect on differences in EF and ESV in rest between both framings.

Conclusion:

In conclusion, results of this study revealed that difference of both 16 and 8 frames data in systolic phase were statistically significant and it seems that because of better efficiency of 16 frames, it cannot be replaced by 8 frames. Further well-designed studies are required to verify these findings.

POPULATION RADIATION EXPOSURE FROM DIAGNOSTIC NUCLEAR MEDICINE PROCEDURES IN TEHRAN 2011-14; TRENDS IN THE LAST 3 DECADES

This study represents an update of Tehran population exposure from the diagnostic nuclear medicine procedures and the annual collective effective dose during 2011-14. The diagnostic nuclear medicine procedures data were collected from 58 out of 60 nuclear medicine centers in Tehran and were composed of the type and frequency of diagnostic examinations, radiopharmaceuticals used, administered activities, and age distribution of the patients. The annual number of examinations per 1000 population increased from 13.73 in 2011 to 22.59 in 2014 with an increase of 64.53% during 4 years. Most frequent examinations were cardiac (71.05%), bone (9.80%) and thyroid (7.26%) averaged over the 5 years. The collective effective dose increased from 807.74 person-Sv in 2011 to 1413.81 person-Sv in 2014. The effective dose per capita increased from 44.06 μSv in 2011 to 120.91 μSv in 2014, could be because of 70% increase of examinations, but ~3.42% increase in the population of Tehran.

Radioprotective Effect of Beta D-Glucan and Vitamin E on Gamma Irradiated Mouse

INTRODUCTION

It is shown that beta-D-glucan is an immunologic system booster with radioprotectory effects. Radioprotectors are chemical components that can alleviate biological damage produced by ionizing radiation.

AIM

This study was designed to investigate the synergistic radioprotectory effects of beta-D-glucan and vitamin E on irradiated mice with ⁶⁰Co source.

MATERIALS AND METHODS

A total of 240 female mice were arranged in four, equal population groups of control group (C), treated group with beta D-glucan (G), treated group with vitamin E (E), and treated group with both beta D-glucan and vitamin E (G+E). Each group was divided into three equal population groups of D6, D7 and D8 exposed to ⁶⁰Co radiation with prescribed total body dose of 6, 7 and 8 Gray (Gy), respectively. After the exposure, the number of survived animals was counted by time, then Lethal Dose_50/30 (LD_50/30), Lethal Dose_50/60 (LD_50/60) and Dose Reduction Factor (DRF) were calculated in all groups and corresponding groups.

RESULTS

Based on the results of current study, treatment of the animals with vitamin E did not change values of LD_50/30 and LD_50/60, in comparison to control group. LD_50/30 and LD_50/60 of treated groups with beta D-glucan and beta D-glucan + vitamin E showed significant difference with those of control group (p<0.01). The DRF values in groups E, G and G + E, were calculated respectively as 1, 1.25 and 1.375 based on LD_50/30, and respectively as 1, 1.17 and 1.33 based on LD_50/60. While values of DRF in groups G and G + E showed significant difference in comparison to that of control group (p<0.01), but the difference between DRF of groups G and G + E was not significant (p=0.395).

CONCLUSION

The findings of study obviously showed that, presence of beta D-glucan in the body of mice, during exposure to ionizing radiation, leads to DRF of higher than one, proving the radioprotectory effect of this agent. Also, we demonstrated that, while vitamin E had no radioprotectory effect on irradiated mice, beta D-glucan in combination with vitamin E increased resistance of mice against ionizing radiation.

Low-level laser therapy with helium-neon laser improved viability of osteoporotic bone marrow-derived mesenchymal stem cells from ovariectomy-induced osteoporotic rats

The purpose of this study was to evaluate the influences of helium–neon (He–Ne) and infrared (IR) lasers on the viability and proliferation rate of healthy and ovariectomy-induced osteoporotic (OVX) bone marrow mesenchymal stem cells (BMMSCs) in vitro. MSCs harvested from the BM of healthy and OVX rats were culture expanded. He–Ne and IR lasers were applied three times at energy densities of 0.6, 1.2, and 2.4??J/cm2 for BMMSCs. BMMSCs viability and proliferation rate were evaluated by MTT assay on days 2, 4, 6, 14, and 21. The results showed that healthy BMMSCs responded optimally to 0.6??J/cm2 using an IR laser after three times of laser radiation. Moreover, it was found that OVX-BMMSCs responded optimally to 0.6??J/cm2 with He–Ne laser and one-time laser radiation. It is concluded that the low-level laser therapy (LLLT) effect depends on the physiological state of the BMMSCs, type of the laser, wavelength, and number of laser sessions. The biostimulation efficiency of LLLT also depends on the delivered energy density. LLLT can enhance the viability and proliferation rate of healthy and especially osteoporotic autologous BMMSCs, which could be very useful in regenerative medicine.

An update on radiation absorbed dose to patients from diagnostic nuclear medicine procedures in Tehran: A study on four academic centers

Purpose:

Use of radiopharmaceuticals for diagnostic nuclear medicine procedures is one of the main sources of radiation exposure. We performed this study with respect to the rapid growth in nuclear medicine in Iran and lack of updated statistics.

Materials and Methods:

The data were obtained for all active Nuclear Medicine Centers affiliated to Shahid Beheshti University of Medical Sciences during 2009 and 2010.

Results:

The most frequently performed procedures were bone (30.16%), cardiac (28.96%), renal (17.97%), and thyroid (7.93%) scans. There was a significant decrease in the number of thyroid scintigraphies with ¹³¹I and ^99mTc-sulfur colloid liver/spleen scans and tremendous increase in the frequencies of cardiac and bone scintigraphies compared to one decade ago.

Conclusion:

Compared to previous studies, there were striking changes in trends of diagnostic nuclear medicine procedures in Tehran. This field is still evolving in the country, and this trend will further change with the introduction of positron emission tomography scanners in future.

Short-term effects of extremely low-frequency pulsed electromagnetic field and pulsed low-level laser therapy on rabbit model of corneal alkali burn

This study was conducted to investigate the effect of combining extremely low frequency-pulsed electromagnetic field (ELF-PEMF) and low-level laser therapy (LLLT) on alkali-burned rabbit corneas. Fifty alkali-burned corneas of 50 rabbits were categorized into five groups: ELF-PEMF therapy with 2 mT intensity (ELF 2) for 2 h daily; LLLT for 30 min twice daily; combined ELF-PEMF and LLLT (ELF + LLLT); medical therapy (MT); and control (i.e., no treatment). Clinical examination and digital photography of the corneas were performed on days 0, 2, 7, and 14. After euthanizing the rabbits, the affected eyes were evaluated by histopathology. The clinical and histopathologic results were compared between the groups. On days 7 and 14, no significant difference in the corneal defect area was evident between the ELF, LLLT, ELF + LLLT, and MT groups. Excluding the controls, none of the study groups demonstrated a significant corneal neovascularization in both routine histopathology and immunohistochemistry for CD31. Keratocyte loss was significantly higher in the MT group than in the ELF, LLLT, and ELF + LLLT groups. Moderate to severe stromal inflammation in the LLLT group was comparable with that in the MT group and was significantly lower than that in the other groups. In conclusion, combining LLLT and ELF was not superior to ELF alone or LLLT alone in healing corneal alkali burns. However, given the lower intensity of corneal inflammation and the lower rate of keratocytes loss with LLLT, this treatment may be superior to other proposed treatment modalities for healing alkali-burned corneas.

One size does not fit all: the merit of absorbed doses to the blood in 131I therapy for differentiated thyroid carcinoma

The amount of 131I necessary for successful ablation in patients with differentiated thyroid cancer (DTC) is still subject to debate. This study investigates the relationship of the absorbed dose of radiation to the blood while administering 131I activity with several other parameters in DTC patients. This prospective study included 90 DTC patients who were classified into three groups according to their level of dosage: 3.7 GBq (38.9%), 5.55 GBq (55.6%), and 7.4 GBq (5.5%). Blood dosimetry of treated patients was performed using external whole-body counting with a Geiger Muller dosimeter located 2 m away from the patients. Dose rate was measured at 2, 4, 5, 24, and 48 h after the administration of radioiodine. Based on the results of whole-body dose rate measurements, 48 h after administration of 3.7, 5.55, and 7.4 GBq of radioiodine, absorbed doses to patients' blood were estimated at 0.49 ± 0.12, 0.71 ± 0.21, and 0.76 ± 0.11 Gy, respectively. Increasing radioiodine dosage from 3.7 GBq to 5.55 GBq significantly increased blood dose, while there was no significant difference in blood dose between radioiodine dosages of 5.55 GBq and 7.4 GBq. The absorbed dose to the blood was significantly correlated to the patients' gender and the presence of lymph node metastases, but it was not significantly correlated to the type of pathology and regional or distant metastases. Ablation activities exceeding 5.55 GBq produce no further increase in the accumulated activity per volume of blood. The literature regarding this issue is scarce, and further studies are required to verify these preliminary results.

Management of gastrointestinal complaints in differentiated thyroid cancer patients treated with (131)I: comparison of the efficacy of pantoprazole, metoclopramide, and ondansetron - a randomized clinical trial

OBJECTIVE

To compare safety and efficacy of pantoprazol , metoclopramide, ondansetron, as compared to placebo, in controlling gastrointestinal (GI) complaints of thyroid cancer patients treated with I-131these patients.

DESIGN

Four-armed, parallel group, single blind, randomized controlled clinical trial, setting: A university hospital, registration: database for clinical trials IRCT2013061713705N1.

PATIENTS

85 patients with differentiated thyroid cancer who received 131I.

MAIN OUTCOME MEASURES

Postradioiodine nausea and vomiting within three days of therapy (primary endpoint); occurrence of adverse reaction.

RESULTS

The patients' characteristics were similar within the study groups. Among the study variables, age, sex, administered dosage, history of previous GI complaints, and history of hyperemesis gravidarum in female patients were not statistically different among the groups (p > 0.05). The results revealed that only ondansetron shows a therapeutic benefit over the placebo in controlling nausea (p < 0.05); however, it does not prevent vomiting (p > 0.05). The other two drugs, pantoprazole and metoclopramide, did not control nausea (p > 0.05) or vomiting (p > 0.05).

CONCLUSIONS

This study may demonstrate that the therapeutic dose of ondansetron could be an effective prophylactic agent in controlling GI complaints in differential thyroid carcinoma (DTC) patients following RAI therapy; however, these preliminary findings should be validated in larger studies.

Population radiation dose from diagnostic nuclear medicine procedures in the Tehran population in 1999-2003: striking changes in only one decade

Use of unsealed radiopharmaceuticals in Iran's nuclear medicine centers has expanded rapidly in the last decade. As part of a nationwide survey, this study was undertaken to estimate the radiation risk due to the diagnostic nuclear medicine procedures performed in Tehran in 1999-2003. During the five years of the study, the data of 101,540 yearly examinations of diagnostic nuclear medicine were obtained for 34 (out of 40) active nuclear medicine centers in Tehran. The patients studied were aged 1 y, 5 y, 10 y, 15 y, and adults (>15 y). Compared to an earlier investigation in 1989 (which was published in 1995), striking changes were found to be occurring in the trends of nuclear medicine in Tehran in a matter of a decade. The frequency of cardiac examinations increased from less than 1% in 1989 to 43.2% (mean of 5 y) in 2003; thyroid examinations, with the relative frequency of higher than 80% in 1989, decreased to 26.7% in the current investigation (averaged for 2001); and the number of overall examinations per 1,000 population of Tehran increased from 1.9 in 1989 to 8.8 in this study (about fourfold). The decrease in relative frequency of thyroid examinations could be attributed to the lower referral policy (mainly by specialists), decreased incidence of goiter due to implementation of programs for iodine enrichment diets, introduction of fine needle aspiration (FNA), and sonography techniques for diagnosis of thyroid disease. The large increase in relative frequency of cardiac examinations could be due to the increase in the number of single photon emission computerized tomography (SPECT) systems in recent years as compared to 1989 in Tehran. The collective effective dose increased from 400 (person-Sv) in 1999 to 529 (person-Sv) in 2003, and the effective dose per capita increased from 34.80 μSv in 1999 to 44.06 μSv in 2003 (average, 35.60 μSv).

Trends of population radiation absorbed dose from diagnostic nuclear medicine procedures in Iran: 1985-1989

In view of the rapid expansion of diagnostic nuclear medicine procedures in Iran, this study was undertaken to examine trends of nuclear medicine practice in the country and to determine the mean effective dose equivalent per patient and per capita. Comprehensive national data covering 93% of all nuclear medicine centers in 1985-1989 were obtained. The total number of nuclear medicine examinations increased by 42% during these years. The relative frequency of thyroid investigations was 84% followed by liver/spleen and bone procedures (7% and 6%, respectively). 99mTc was the radionuclide of choice for 86% of investigation while 131I alone accounted for 59% of collective effective dose equivalent. The annual average number of nuclear medicine procedures per 1,000 people was 1.9. For the thyroid, the highest number (48%) of patients investigated was in the 15-29 y age group and the lowest (3%) was in the > 64 y age group. The male to female ratio of thyroid and cardiac patient was 0.18 and 3.64, respectively. The numbers of males and females studied for the remaining eight procedures were less frequent and about the same. The mean effective dose equivalent per patient and per capita was about 4.3 mSv and 8 microSv, respectively. 131I was responsible for most of collective effective dose equivalent produced by nuclear medicine. Therefore, future efforts should be concentrated on dose reduction for diagnostic 131I tests.