[Iodine intake in Portuguese school children]. / Aporte do Iodo nas Crianças das Escolas em Portugal.

OBJECTIVE: The aim of the present study was to evaluate iodine intake in portuguese school children in order to inform health authorities of eventual measures to be implemented. INTRODUCTION: Iodine is the key element for thyroid hormone synthesis and its deficiency even mild, as found in other European countries, may have deleterious effects in pregnancy resulting in cognitive problems of offsprings. In Portugal there are no recent data on iodine intake in schoolchildren. POPULATION AND METHODS: 3680 children aged 6-12 years of both sexes, from 78 different schools were studied. Iodine intake was evaluated trough urine iodine (UI) determinations using a colorimetic method. RESULTS: The global median UI value was 105.5 µg/L; the percentage of children with UI <100 µg/L was 47.1%, corresponding to 41% of the studied schools. The percentage of values <50 µg/L was 11.8%. The male gender, the south region of the country and the distribution of milk in school were significantly linked with a higher iodine elimination. DISCUSSION: Our global results point to a borderline/ mildly insufficient iodine intake in the portuguese school population. However 47% of the children had UI under 100 µg /L. The comparison of our results with the available data from 30 years ago, point to a considerable improvement, due to silent prophylaxis. Male gender, geographical area and milk distribution influenced positively iodine intake.The importance of milk has been referred in numerous papers. CONCLUSIONS: The study of UI in the Portuguese school population points to a borderline iodine intake. However, in 47% of children iodine intake was inadequate. Compared with data from the eighties, a considerable increase in iodine elimination was found. Taking into account the potencial deleterious effects of inadequate iodine intake, a global prophylaxis with salt iodization has to be considered.

[Quality of care in diabetic outpatient clinics]. / Avaliação da qualidade de cuidados numa consulta de diabetes.

UNLABELLED: Type 2 Diabetes Mellitus affects an increasing number of people throughout the world. Several studies have shown that it is possible to prevent and minimize type 2 diabetes complications, be it treated appropriately over time. This study aimed to determine the quality of care provided to type 2 diabetic patients in our institution, through metabolic control and risk factors evaluation. SUBJECTS AND METHODS: We reviewed the medical records of 776 type 2 diabetic patients, followed at our outpatient clinic between 1998-2004. RESULTS: A total of 588 patients were included in the study, with a mean age of 66,8 ± 27,2 years. 58% were men. HbA1c levels averaged 7,2 ± 1,6. 57% had HbA1c = 7%. 25,3% met the target blood pressure of 130/80 mmHg; 48% met the goal LDL cholesterol level < 100 and 80% < 130 mg/dl. 6,8% of patients met the combined ADA goal for BP, LDL and HbA1c. Concerning therapeutic regimens: 71,5% used oral hypoglycaemic agents (OAD) alone (52,1% of these were using 2 or more agents); 28,5% were treated with insulin (16,2% in combination with OAD). 52,1% of the patients were anti-aggregated with aspirin. CONCLUSIONS: The metabolic control (HbA1c) and LDL values were favourable in our patients sample, comparing to other studies. The percentage of patients treated to the recommended BP of 130/80 mmHg is consistent with the literature. Only 6,8% of patients met the combined ADA goal for BP, LDL and HbA1c. Despite our comparable results to published data, we would like to highlight the difficulty to accomplish international recommendations to metabolic and risk factors control in clinical practice and the necessity of an aggressive approach to diabetes treatment.

Iodine intake in Portuguese pregnant women: results of a countrywide study.

BACKGROUND: Iodine is the key element for thyroid hormone synthesis, and its deficiency, even moderate, is harmful in pregnancy, when needs are increased, because of its potential deleterious effects on fetal brain development. In Portugal, no recent data on iodine intake exists. The objective of this countrywide study was to analyze iodine status in pregnant Portuguese women in order to propose adequate measures to the health authorities. SUBJECTS AND METHODS: Using a fast colorimetric method, urine iodine concentration (UIC) was evaluated in 3631 pregnant women followed in 17 maternity hospitals from hinterland and coastal areas in Continental Portugal and the Portuguese islands of Açores and Madeira. RESULTS: Median UIC value was 84.9 µg/l (range 67.6-124.1) in Continental Portugal, 69.5 µg/l in Madeira, and 50.0 µg/l in Açores. The percentage of satisfactory values (>150 µg/l) was 16.8, ranging from 8.8 to 34.1 in the Continent, and being 8.2 in Madeira and 2.3 in Açores. The percentage of values below 50 µg/l was 23.7, ranging from 14.0 to 37.4 in the Continent, 33.7 in Madeira, and 50.0 in Açores. CONCLUSIONS: Our results point to an inadequate iodine intake in pregnant women assisted in most Portuguese maternity hospitals. Considering the potential deleterious effects of inadequate iodine supply in pregnancy, iodine supplementation is strongly recommended in this period of life.

[Superior vena cava syndrome and intrathoracic goiter: an unusual presentation in the 21st century]. / Bócio mergulhante e síndroma da veia cava superior: uma apresentação rara no século XXI.

We present a rare case of retrosternal goiter complicated with superior vena cava síndrome (SVCS) with impressive clinical signs. After clinical and imagiologic confirmation, total thyroidectomy was performed with complete remission of compressive signs.

The relationship between body mass index and educational level in young Portuguese males: 1995 and 1999 cohorts.

INTRODUCTION: Over the last decades, a progressive increase in height and weight has been observed throughout Europe. Increase in weight has been more marked however, with a resulting increase in overweight and obesity prevalence. RESULTS published have analyzed the relationship between body mass index (BMI) and educational level. Most studies indicate an inverse relationship between BMI and educational level in developed countries. OBJECTIVE: This study's main objective was to evaluate the relationship between BMI and educational level (years of schooling) in young Portuguese males in 1995 and 1999. METHODS: Transverse study of data (BMI and years of schooling) from the military inspection records of virtually the entire Portuguese male population with an average age of 20 years, examined in 1995 and 1999, totaling 81 363 and 71 254, respectively. Four classes of BMI (<20, 20-24.9, 25-29.9 and > or =30 kg/m2) and four schooling levels (<5, 5-9, 10-12, and >12 years) were considered. We applied the chi2 test for associations between BMI and educational level and the odds ratio to quantify categorical variables. The significance level was 5%. RESULTS: In 1995, 15.2% were overweight (BMI> or =25 years), increasing to 20.8% in 1999. The percentage of obesity (BMI> or =30 years) was 1.4% in 1995 and 2.2% in 1999. The percentage of overweight and obesity increased directly in line with the increase in educational level, both in 1995 and 1999. In 1995, the percentage of subjects with obesity according to years of schooling was as follows: <5 years--1.4%; 5-9 years--1.4%; 10-12 years--1.5% and >12 years--1.7%. In 1999, the results were as follows: <5 years--1.4%; 5-9 years--2.2%; 10-12 years--2.8% and >12 years--3.2%. CONCLUSIONS: We can conclude that the prevalence of overweight and obesity in young male Portuguese increased in the last decade and that, unlike most developed countries, the higher the level of education, the greater the percentage of overweight and obesity, both in 1995 and 1999.

[Prevalence of type 1 diabetes mellitus in Portugal, 1995-1999: cohort of young men]. / Prevalência da diabetes mellitus tipo 1 em Portugal, 1995-1999 coorte de jovens do sexo masculino.

We designed a study to assess the prevalence of type 1 diabetes mellitus among the Portuguese population. The study was based on a cohort of young Portuguese men inspected at the different recruitment Centres of the Portuguese Armed Forces in 1995 and 1999. We found a prevalence of 1.28 and 1.58 cases per 1,000 young men aged 20 (median), in 1995 and 1999, respectively. As far as the geographical distribution of this population was concerned, the recruitment centres (RC) with highest prevalence of diabetes in 1995 were that of Oporto, Évora and Lisboa. In 1999, highest prevalence was in Évora, Faro and Lisbon. The greatest increase was found at the RCs in Faro, Évora and Vila Real. Although the regional asymmetries are not very significant, they point to a higher prevalence in the southern region and in the urban areas of Lisbon and Oporto.

[Arterial microangiographic aspects of the temporal lobe]. / Aspects microangiographiques artériels du lobe temporal.

Human brain microvascularisation, whose general patterns are well known, still raises unanswered questions, such as the ones concerning regional arterial angioarchitectonic variations. Following other papers already published about the Temporal Plan and the Prefrontal Cortex, this article presents new elements on the arterial microcirculation's morphology of the Temporal Lobe in its whole and in the different areas that constitute it. The microangiography is the first choice method for such research, allowing to observe and describe in detail multiple aspects that have not been pointed out before.