is an 8mm thyroid nodule big
The postoperative histopathology results of 301 patients with malignant nodules are presented in Table Table3.3. How did they decide it was cancer in my case, or did they just assume? Tang AL, Falciglia M, Yang H, Mark JR, Steward DL. https://www.mayoclinic.org/diseases-conditions/thyroid-nodules/symptoms-causes/syc-20355262. They are found . Nodules subject to FNA show step-wise decline in malignancy rates by size, demonstrating that size alone should not be considered as an independent risk factor. doi: 10.7759/cureus.31677. I see a new oncologist Wed. Aug 9th. Unenhanced magnetic resonance imaging of papillary thyroid carcinoma with emphasis on diffusion kurtosis imaging. In conclusion, nodule size per se is not an absolute criterion of safety. Nevertheless, Gandolfi et al. Put in simple terms a thyroid nodule is a piece of tissue in your thyroid gland that is different from the surrounding tissue (1). Nodules in the lower portion of the lobes are believed to be at least risk for cancer. These nodules are widespread, but most are benign. 8600 Rockville Pike Unauthorized use of these marks is strictly prohibited. There are a number of well-established predictors of malignancy in thyroid nodules, but thyroid nodule size has been a cause for concern for many researchers and results of the studies are still controversial about their probability of malignancy. I had several treatments. When I told her I was afraid to find out I if I have cancer, she said, "Why"? Is nodule size an independent predictor of thyroid malignancy? In nodules subject to FNA, false negative diagnoses were highest (6-8%) in nodules 3-6 cm, mostly due to encapsulated follicular variant of papillary carcinoma. Malignant Nodules Can Be Identified by Their Location in the Thyroid Small ( <10 mm) thyroid nodules; how aggressively should they be managed? Do I Need a Biopsy or Surgery for My Thyroid Nodule? https://pubmed.ncbi.nlm.nih.gov/19415954/, https://pubmed.ncbi.nlm.nih.gov/21268762/, http://www.mmj.eg.net/article.asp?issn=1110-2098;year=2019;volume=32;issue=3;spage=1142;epage=1148;aulast=El-Gammal, https://pubmed.ncbi.nlm.nih.gov/15670190/, https://pubmed.ncbi.nlm.nih.gov/19598221/, https://pubmed.ncbi.nlm.nih.gov/27313663/, https://www.ijsurgery.com/index.php/isj/article/view/984, https://pubmed.ncbi.nlm.nih.gov/22340102/, https://www.hilarispublisher.com/abstract/predictors-of-malignancy-in-patients-with-solitary-and-multiple-thyroid-nodules-26059.html, https://pubmed.ncbi.nlm.nih.gov/23428179/, https://pubmed.ncbi.nlm.nih.gov/28181427/, https://pubmed.ncbi.nlm.nih.gov/28052718/, https://pubmed.ncbi.nlm.nih.gov/19041019/, https://pubmed.ncbi.nlm.nih.gov/21633868/, https://pubmed.ncbi.nlm.nih.gov/19296123/, https://pubmed.ncbi.nlm.nih.gov/10828810/, https://onlinelibrary.wiley.com/doi/abs/10.1002/lary.24784, https://pubmed.ncbi.nlm.nih.gov/23978950/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5904481/, https://pubmed.ncbi.nlm.nih.gov/16835280/, https://pubmed.ncbi.nlm.nih.gov/15481700/, Size of thyroid nodules of cancer patients (n=301). @cindiwass Hashimoto's thyroiditis causes thyroid nodules. FOIA If not, no harm done. The https:// ensures that you are connecting to the Doctors will recommend further testing if necessary. While most thyroid nodules are non-cancerous (Benign), ~5% are cancerous. Hong MJ, Na DG, Baek JH, Sung JY, Kim JH. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Conclusions: Thyroid nodule size is inversely related to malignancy risk, as larger nodules have lower malignancy rates. Thyroid nodule characteristics The size (largest dimension in millimeters) and the location (right lobe, left lobe, or isthmus) were recorded for each nodule according to the description in the pathology reports. Unauthorized use of these marks is strictly prohibited. Size at ultrasound shows relatively good correlation with final pathologic size. Most thyroid nodules are benign; therefore, ultrasound and fine needle aspiration (FNA) are integral in cancer screening. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. I've had two already on my thyroid, and one iodine pill uptake. I'd like to keep living, but I can't believe I reached this age anyway. Moreover, in our study, we found that the majority of patients with thyroid cancer had serum TSH concentration in a normal range, and it was statistically significant (p<0.001). Currently, there is no definitive answer. 2013 Feb;98(2):564-70. doi: 10.1210/jc.2012-2968. found that the incidence of thyroid cancer was significantly higher in nodule size greater than or equal to 4 cm [20]. I have that and have had a needle biopsy to", "I really don't think you asked a harsh question, I've been going over that myself. We found out that thyroid cancer is more prevalent among patients ages 45 years and above as compared to patients aged below 45 years (p<0.001). Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Thyroid Nodule: Causes, Risk Factors, and Symptoms - Healthline Carrillo et al. Cancer risk can differ based on whether nodules are found in the isthmus or the lobar (winged) areas of the thyroid. government site. Thyroid Nodule Size and Prediction of Cancer: A Study at Tertiary Care 2022 May 20;12(3):148-163. doi: 10.5662/wjm.v12.i3.148. This is a procedure in which a small needle is inserted into the Thyroid Nodule and used to withdraw (aspirate) cells. If concern arises about the possibility of cancer, the doctor may simply recommend monitoring the nodule over time to see if it grows. Cancers (Basel). Continue with Recommended Cookies. small lung nodules, double in size in 72 days WORRIED. 10. A lung nodule is a small irregular growth in your lungs that's smaller than 30 millimeters (mm) (1.2 inches) in diameter. Witczak et al. It's an easy test. Years ago they didn't use protective covering when taking x-rays of teeth. Otolaryngology, Ohud Hospital, Madinah, SAU, 4 Current guidelines recommend biopsy of many thyroid nodules >5 to 15 mm in diameter. The exclusion criteria were: (1) CT detection of solid nodules; (2) presence of multiple nodules; (3) other histological diagnosis except lung adenocarcinoma, such as benign nodule, squamous-cell . Nodular size of 1 - 1.9 cm was more prevalent among cancer patients than in benign cases (p<0.001). Is 8mm nodule a size to worry about Cancer Survivors Network Hence, we suggest that solitary thyroid nodules are a predictor of malignancy. We are not able to see you or your history or lab normal values here. I guess they will want to do a FNA, but I know that is not always a correct indicator of cancer. We discuss these options below. An official website of the United States government. Bouvet M, Feldman JI, Gill GN, Dillmann WH, Nahum AM, Russack V, Robbins KT. The aim of this review is to present currently available data regarding indications for aggressive treatment of small (<10 mm) thyroid nodules. It is safe to use during pregnancy and is also a, Medullary thyroid cancer (MTC) is a rare type of thyroid cancer. reported a high incidence of malignancy more in females than males [8, 11]. They're very common and estimated to occur in anywhere from 2% to 24%. Statistical significance was defined as a p-value of <0.05. A thyroid nodule is a solid or fluid-filled lump found within the . Shin J, Caragacianu D, Randolph G. Risk of thyroid cancer based onthyroid ultrasound imaging characteristics: results of a populationbased study. (n.d.). Malignant nodules were mostly prevalent in patients aged 45 and above (p<0.001). This test can help evaluate nodules that cause hyperthyroidism. 2022 Oct 3;14(19):4826. doi: 10.3390/cancers14194826. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. They're common, almost always noncancerous (benign) and usually don't cause symptoms. (2014). The echogenicity refers to the brightness of a thyroid nodule relative to the rest of the thyroid tissue. All nodules (regardless of FNA status) demonstrate a risk trough at 2 cm. Bookshelf What is Considered a Large Thyroid Nodule? - StuffSure the hot nodule is probably causing you to be hyperthyroid but only labs can tell you that. Background: Moreover, the worldwide incidence of thyroid cancer has been increasing over the past decade, due to the diagnosis of asymptomatic disease secondary to the advancement and improvement of diagnostic technology and increased surveillance [4]. 8mm nodule on thyroid | HealthTap Online Doctor A scientist will then examine the tissue sample under a microscope to check for the presence of cancerous cells. For statistical analysis, descriptive statistics and Pearson's chi-squared (2) test were used, and missing data were excluded. Thyroid nodules: does the suspicion for malignancy really justify the increased thyroidectomy rates? Of the 455 not subject to FNA, 11% were malignant. (oh, well), I think you are thinking well. These lumps can be solid or fluid-filled, in which case they are referred to as cysts. Bookshelf Created for people with ongoing healthcare needs but benefits everyone. The incidence of small thyroid malignancy has increased. Can a benign nodule in a thyroid turn into bad ones. doi: 10.31744/einstein_journal/2022AO6747. It depends on the cell type on how serious it is, you need to have an ultrasound guided biopsy for tissue. As it was explained to me, if that comes up w/cancer cells, they will take the whole thyroid out. I and my siblings have all outlived the ages at which my parents passed away. What is a not active nodule on my thyroid? How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821499/, https://www.thyroid.org/wp-content/uploads/publications/ctfp/volume7/issue1/ct_public_v71_6_7.pdf, https://www.hormone.org/diseases-and-conditions/thyroid/thyroid-nodules, New clues to slow aging? However, a study by Jaheen et al. 2010 Dec;19(4):e130-9. When Should you Worry About Thyroid Nodules? 6 Signs to Know 1 I guess in 2008 It was found on a Cat scan but I was never told about it and at that time it was 5mm. and ElGammal et al. Here, we will talk about what is considered a large thyroid nodule and what this may mean for your health. Frates MC, Benson CB, Doubilet PM, et al. Federal government websites often end in .gov or .mil. We would like to thank the staff of the medical records at King Abdulaziz Medical City for their valuable efforts in retrieving medical records and maintaining their availability. The ATA also note that solid hypoechoic thyroid nodules have a higher chance of becoming cancerous compared to cystic or fluid-filled lesions. It is related to the formation of the thyroid gland during, A multinodular goiter is an enlarged thyroid gland with several nodules. HHS Vulnerability Disclosure, Help I have a very large nodule on my thyroid, does it mean I have cancer? A doctor may also discover thyroid nodules during a routine examination or an imagining test of a persons head and neck. reported similar results in their studies stating that thyroid cancer among patients aged greater than or equal to 45 years was statistically significant than those aged less than 45 years [7, 8]. breathing difficulties. The procedure is usually done in your doctor's office, takes about 20 minutes and has few risks. reported that thyroid nodule size is inversely related to malignancy risk, as larger nodules have lower malignancy rates [17]. I have the protective cover put on my neck when I have x-rays at the dentist. I have been taking 75 mcg for a while now. Epub 2012 Dec 28. J Am Coll Surg. Relationship between thyroid nodule size and incidence of thyroid cancer. Cavallo A, Johnson DN, White MG, et al. Thyroid Ultrasound: a common imaging test used to evaluate the structure of the thyroid gland. In addition, Cavallo et al. Its interesting that the 8mm didn't change in size and a good thing. Also, Reynolds et al. jojo's Member Posts: 2 September 2016 edited September 2016 #8 My mind is still keeping me going. doi: 10.1016/j.suronc.2010.06.003. A total of 987 patients presented with thyroid nodule ( 1 cm) underwent thyroid nodule FNA and subsequent thyroidectomy during the study period. and transmitted securely. What does the thyroid with nodules look like? A thyroid nodule biopsy is a procedure that removes a small piece of tissue from the thyroid gland for testing. This suggests a possible threshold effect. A large thyroid nodule is one that is at least 1 cm in size. Hurtado-Lopez LM, Carrillo-Muoz A, Zaldivar-Ramirez FR, Basurto-Kuba EOP, Monroy-Lozano BE. Thyroid pain. J Clin Endocrinol Metab. In fact, most thyroid nodules are benign (noncancerous). Instead, they reported that thyroid cancer is common among people aged 45 years and below [10]. Thyroid nodule size is inversely related to malignancy risk, as larger nodules have lower malignancy rates. Most commonly, an aggressive management (including surgery) is recommended for thyroid nodules measuring >10 mm. Also, an increase in the proportion of the other rare types of malignancy, such as medullary, anaplastic carcinoma, and thyroid lymphoma was noted with increasing nodule size (p<0.001) (Table (Table44). However, certain conditions can increase the risk of developing thyroid nodules, including: If a doctor detects a hypoechoic thyroid nodule on an ultrasound examination, they may recommend that the person undergoes additional testing or surgery. Connect with thousands of patients and caregivers for support, practical information, and answers. Alshahrani AS, Junaid M, Aldosari AA, Amer KA, Al Qannass AM. It is not a substitute for professional medical advice. The vast majority more than 95% of thyroid nodules are benign (noncancerous). Carrillo JF, Frias-Mendivil M, Ochoa-Carrillo FJ, Ibarra M. Impact of nodule size onprevalence and post test probability of malignancy: a systemic review. A thyroid nodule is a lump in or on the thyroid gland. 2012 Jan;19(1):45-51. doi: 10.1245/s10434-011-1807-z. I will be looking forward to hearing how the results of the tests you will be having. By using our website, you consent to our use of cookies. Thyroid Nodules: Advances in Evaluation and Management | AAFP Hypoechoic thyroid nodule: What does it mean and risk of cancer? In agreement with our study, Paulet al. You wil of individual nodules on a thyroid scan may not, in and of themselves, imply hyper or hypothyroidism, which are diagnoses based on systemic symptoms Biopsy of a thyroid nodule which is "inconclusive" may need a repeat biopsy. Sounds like, though, you're doing great. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Use of this online service is subject to the disclaimer and the terms and conditions. Find out more, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Moreover, SmithBindman et al. The majority of thyroid nodules are benign, with 5% to 15% being malignant [1]. Thyroid Cancer. The prevalence of thyroid cancer was statistically significant between solitary nodules and MNG (p<0.001). Keywords: Thyroid nodules range in sizeyour doctor will decide what to do depending on their size. Thyroid nodule shape and prediction of malignancy. Thyroid nodules are common, occurring in 40% of women and 30% of men during their lifetime. Hence, its worth suggesting that thyroid nodule size up to 2 cm is associated with an increased risk of thyroid cancer, but further growth beyond 2 cm no longer influences cancer risk. Thyroid function was normal in almost all patients (93.9%), and 270 patients (27.4%) gave a positive family history of thyroid cancer. Just to let you know, where I was a teenager my mother sent me to a dermatologist because I had a little bit (not a lot) of acne. Small nodules were found in both of my lungs in March. Ultrasound guidance helps the doctor to ensure that the needle is inserted into the Thyroid Nodule and not into surrounding tissues. Then your physician will be able to tell y Thyroid nodules comprise many types, but can generally be classified by way of a thyroid uptake scan as hot or cold. Risk of thyroid cancer based on thyroid ultrasound findings [Fact sheet]. My friend is a former nurse and she is more up on the treatments for her ailments than I am. I guess she wants to see if I have nodules elsewhere nearby. National Library of Medicine Lori. Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU, 3 The https:// ensures that you are connecting to the sharing sensitive information, make sure youre on a federal Reynolds RM, Jennifer W, Stockton DL, et al. eCollection 2022. See an oncologist. Vaccarella S, Franceschi S, Bray F, et al. Do I take the treatment and hope I keep living longer than if I didn't take the treatment, or do I not take the treatment. People with benign Thyroid Nodules may be followed with periodic examinations and ultrasounds every 6-12 months depending on their individual risk factors.if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'stuffsure_com-large-mobile-banner-1','ezslot_5',183,'0','0'])};__ez_fad_position('div-gpt-ad-stuffsure_com-large-mobile-banner-1-0'); There are many possible causes of thyroid nodules, including: Cysts: Fluid-filled sacs that can form on the thyroid. An official website of the United States government. Does the CT scan should the nodule is now 8 mm or cm? Moreover, Megwalu et al. The thyroid is a gland located at the base of the neck. Five hundred sixty-seven patients (57.4%) had multiple nodules, and 420 patients (42.6%) had solitary nodules. Thanks LoriI appreciate info Lori. Clipboard, Search History, and several other advanced features are temporarily unavailable. A thyroid nodule is an unusual lump (growth) of cells on your thyroid gland. Risk was similar (20%) for nodules 2 cm. Malignant nodules were found in 30.5%of the studied cases. The initial screening and triage of thyroid nodules are carried out using the fine needle aspiration (FNA), which has been broadly accepted as the most cost-effective and accurate tool [5]. thyroid nodule, malignancy risk, thyroid malignancy, thyroid, thyroid nodule size, fine-needle aspiration. This is not a typical description of a thyroid nodule. government site. As I mentioned in my description, I just found out that I have a 9mm nodule on my thyroid. Thyroid Nodules: When to Biopsy? - Patient Care Online On the contrary, out of 420 patients with solitary thyroid nodules, there were 192 patients with malignant nodules and 228 with benign nodules. Smith-Bindman R, Lebda P, Feldstein VA, et al. But now the time has come for me to go further. Personally, I do not want to ever have to be totally dependent on others but I hope to live as long as I can be sound and live life well. Their age rangedbetween 18-80 years, and (62%) were aged 45 years and above. Laryngoscope. Lung Nodule Size Chart: What the Size of Nodules Indicates Alexander EK, Marqusee E, Orcutt J, et al. HHS Vulnerability Disclosure, Help Glad to hear your mind is still going. To conclude, the findings of this study suggest that an increase in thyroid nodule size impacts cancer risk in a nonlinear fashion. I go to pulmonary doctor Feb 23 for his opinion but I have been worried sick over this. Ultimately, the decision of whether or not to biopsy (remove and test) a thyroid nodule is based on a variety of factors, including size, appearance on imaging tests, and patient symptoms.if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'stuffsure_com-box-4','ezslot_4',180,'0','0'])};__ez_fad_position('div-gpt-ad-stuffsure_com-box-4-0'); If you have any concerns about a Thyroid Nodule, please consult your doctor. The authors have declared that no competing interests exist. Thyroid Nodules | Johns Hopkins Medicine Radiofrequency ablation therapy for large benign thyroid nodules Currently, there is no definitive answer. Size, Number, and Distribution of Thyroid Nodules and the Risk of official website and that any information you provide is encrypted We are all different but we support you in your journey and we can relate our experiences. The thyroid gland makes thyroid hormone, which helps to regulate the bodys metabolism. Thyroid cancer was more prevalent in males than females, and in patients who were older than or equal to 45 years. Bethesda, MD 20894, Web Policies Thyroid nodules are usually measured by their largest diameter in centimeters (cm). Any time a lump is discovered in thyroid tissue, the possibility of malignancy ( cancer) must be considered. Sakajiri RK, Rahal Junior A, Francisco Neto MJ, Queiroz MRG, Garcia RG, Martins LAL, Malerbi DAC. The majority of thyroid nodules are benign, with 5-15% being malignant. Then I had radiation which burned my skin but they continued to finish the 42 radiation treatments. Following a total thyroidectomy, people need to take hormone replacement tablets for the rest of their lives to prevent symptoms of hypothyroidism. Thyroid Nodules | American Thyroid Association Connect with thousands of patients and caregivers for support and answers. government site. These nodules vary in both size and consistency and it is these features that make them worrisome (or not). reported that there was no significant difference between the >4 cm group and the <4 cm group in terms of malignancy (p=0.91) [15]. Of the 548 subject to FNA, 38% were malignant. It sounds like a harsh question, but you seem to be a practical person. I have been told not to eat soy because of a test I had. The term thyroid nodule refers to an abnormal growth of thyroid cells that forms a lump within the thyroid gland. Thyroid noduleshave become relatively common in clinical practice,and their prevalence increases with age. A week later I got the results and well. Doctors may also recommend surgery for people with noncancerous thyroid nodules that are causing symptoms such as vocal changes and swallowing or breathing difficulties. We hypothesize that increased nodule size at ultrasound does not predict malignancy and correlation between nodule size at ultrasound and pathologic exam is good. Risk of thyroid cancer based on thyroid ultrasound findings Epidemiology and prevention. Nodule size at ultrasound, FNA diagnosis by Bethesda category, size at pathologic examination, and final histologic diagnosis were recorded. In order to diagnose and treat thyroid cancer at the earliest stage, most thyroid nodules need . Bohacek L, Milas M, Mitchell J, Siperstein A, Berber E. Ann Surg Oncol. reported that all patients with thyroid cancer in their study had normal thyroid function [8]. A nodule was picked up on my thyroid in 2018 and biopsy came back inconclusive it'd now 2021 should i have had another biopsy taken i haven't been diagnosed with a thyroid condition but i've not been since jan 2020? Follow-up of atypia and follicular lesions of undetermined significance in thyroid fine needle aspiration cytology. reported that high serum TSH level is an independent risk factor of thyroid cancer [13]. 17. Throid nodule size at ultrasound as a predictor of malignancy and final pathologic size. Larger nodules and fast growing nodules can indicate malignancy, or thyroid cancer. I assume this means the nodule is not "cold" on a nuclear thyroid scan. found that MNG were statistically significant for malignancy compared to solitary thyroid nodules [8]. However, 20-25% of samples return indeterminate, making FNA imperfect [6]. Careers. It is quite a job keeping up with the medical science. Thyroid nodules are usually measured by their largest diameter in centimeters (cm). Thyroid-related mortality has remained constant despite the increasing incidence of thyroid carcinoma. So is mine, and honestly, it gets better with age. I guess the first step would be to take a fine needle aspiration. How does someone get nodules on their thyroids? US-FNA is usually done in an outpatient setting such as a hospital or radiology center. Am I rich to believe it is cancer still and to start fighting it right away? Thyroid nodule: an abnormal growth of thyroid cells that forms a lump within the thyroid. Thyroid nodules are detected by ultrasonography in up to 68% of healthy patients. In nodules subject to FNA, false negative diagnoses were highest (6-8%) in nodules 3-6 cm, mostly due to encapsulated follicular variant of papillary carcinoma. These type of nodules are usually solid rather than a fluid-filled lesion. Bethesda, MD 20894, Web Policies Before You are wise to take the offensive. 08. Hughes DT, Haymart MR, Miller BS, Gauger PG, Doherty GM. The thyroid gland is located in the lower part of the neck, just below the Adams apple. Epub 2011 Jun 2. an enlarged thyroid gland, known as a goiter. Anything under 3cms is considered a nodule and some people have calcified nodules in their lungs forever, just part of the aging process. Also, Hong et al. I have a couple of questions, but let's say they don't find cancer cells if they give me a FNA. Predictors of malignancy in solitary nodule thyroid. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. This "unusual" tissue is often in a defined area or mass which is referred to as a "nodule". Thyroid nodules occur when unusual cell growth creates a lump in one of the lobes. Many thyroids have nodules and some thyroids have many. Now if it hadn't grown then nothing but quarterly scans would have been done. Accessibility My scan shows I have thyroid nodules. Should I be worried? Nodules are often biopsied to make sure no cancer is present. I have multiple nodules and over a few years, they have reduced in size after I began taking natural desiccated pig thyroid hormones. US-FNA involves insertion of the needle into the Thyroid Nodule using ultrasound guidance. Thin-slice computed tomography enables to classify pulmonary subsolid When to Worry About Thyroid Nodules | Orlando | UCF Health As shown in Table Table1,1, the studied patients comprised of 689 females (69.8%) and 298 males (30.2%). Additionally, Shin et al. hi, I had my middle right lung lobe removed due to cancer. 8600 Rockville Pike When analysis of nodule size was compared with the type and distribution of thyroid malignancy, papillary carcinoma was predominant in nodular size of 1.0-1.9 cm, and follicular carcinoma was found significantly in nodule size 4 cm.Steven Furtick Family, What A $50,000 Wedding Looks Like, Hever Castle Fun Facts, Nas Fallon Commanding Officer, Articles I