Description of thyroid disorders the year before conception: a population-based study.

Objective: This study aimed to monitoring the prevalence of previously identified thyroid disorders and hypothyroidism monitoring before pregnancy. Material and methods: A retrospective cross-sectional study of women whose pregnancies occurred between 2014 and 2016 was conducted, including 120,763 pregnancies in Catalonia (Spain). The presence of thyroid disorders in women was based on disease diagnostic codes and/or prescription of levothyroxine or antithyroid drugs. To evaluate the thyroid disorder diagnosis and monitoring, thyrotropin (TSH), free T4 (FT4), antiperoxidase antibody (TPOAb), and anti-TSH receptor antibody (TRAb) records were gathered and categorised according to the reference values of each laboratory. Results: The prevalence of recorded thyroid disorders before the last menstrual period was 5.09% for hypothyroidism and 0.64% for hyperthyroidism,showing a significant increase with age. A thyroid monitoring test was not performed in the year before the last menstrual period in approximately 40% of women with a known thyroid disorder. Amongst the women with hypothyroidism who underwent a TSH test, 31.75% showed an above-normal result. Amongst women previously unknown to have thyroid disorders, 3.12% had elevated TSH levels and 0.73% had low TSH levels. Conclusion: A high percentage of Catalan women with a known thyroid disorder were not properly monitored during the year before pregnancy. Amongst those monitored, more than one-third had TSH values outside the reference range. Therefore, it is important to evaluate women with thyroid disorders during pre-pregnancy visits.

[Differences in the quality of life of patients with oropharyngeal dysphagia according to the place of residence: impact on food selection and type of diet]. / Diferencias en la calidad de vida de pacientes con disfagia orofaríngea según el lugar de residencia: impacto en la selección de alimentos y el tipo de dieta.

INTRODUCTION: Background: dysphagia is a disabling, uncomfortable symptom with repercussions on daily basic aspects of well-being. The SWAL-QoL test is validated for checking dysphagia's impact on quality of life (QoL). Methods: a descriptive cross-sectional study. Randomized patients from our in-house Nutrition & Dietetics database. Telephone interviews directly with patients or caregivers. SWAL-QoL test, 11 sections: swallowing, eating, symptoms, food selection, communication, fears, mental health, fatigue, and social function. A 1-5 Likert scale was adjusted and final results were linearly transferred to 0-100 (100 being best positive score). Results as follows: 0-49 severe impact (SI), 50-70 moderate impact (MI), and 71-100 mild impact or no impact (DI/NI). Variables: gender, age, days with treatment, residence: Home (H)/nursing home (NH), indication of commercial thickener (CT) by V/V test: nectar (N), honey (H), pudding (P), days with CT, type of diets; pureed (PD), soft diet (SD), mixed(P&S/D), regular (RD), SWAL-QoL sections. Results: a total of 202 patients with a mean age of 85 years (23-103); IQR: 12. Mostly women, 57.9 %. Dwelling: 43.1 % H/56.9 % NH. SWAL-QoL: SI affects 19.3 %, 59.9 % MI and 20.8 % DI/NI. Using less thickener proved a better QoL; SI in pudding 21.1 % vs nectar 15.3 %, p = 0.04. Diets included 66.3 % PD; 3 % SD; MD, 21.3 %, and RD, 9.4 %. At NH 86.1 % of PD vs 40.2 % at H, p < 0.001. Direct impact of diet on QoL: 30.8 % on DI or no impact of grouped diets vs 15.7 % with PD, p = 0.016. Analysing each section by H/NH, significant difference between fears, higher at H, 57.01 ± 36.41 vs NH, 48.70 ± 27.03, p < 0.001; worse mental health for NH, 66.44 ± 34.30 vs H, 47.48 ± 24.06, p < 0.001; better food selection for H, 75.86 ± 34.12 vs NH, 68.17 ± 33.60, p < 0.01. Conclusions: defining QoL contributes to a better understanding of patient needs. More information to confront their fears is helpful to adjust the texture of liquids properly. Increasing adaptations of diets and diversity in food selection are needed especially in those living in NH.

INTRODUCCIÓN: Introducción: la disfagia es un síntoma invalidante, incómodo, con repercusiones en aspectos básicos del bienestar. El test SWAL-QoL esta validado para comprobar el impacto de la disfagia en la calidad de vida (QoL). Métodos: estudio descriptivo transversal (enero 2018). Pacientes con tratamiento de espesante aleatorizados a partir de la base de datos interna de la Unidad de Nutrición y Dietética. Entrevistas telefónicas al paciente o cuidador. Test SWAL-QoL, 11 secciones: carga de enfermedad, síntomas, selección de alimentos, apetito, duración comidas, miedos, comunicación, salud mental, sueño/descanso, fatiga y afectación social. Puntuación ajustada con escala Likert (1-5). Resultados finales transferidos linealmente de 0 a 100 (mejor puntuación positiva). Interpretación: 0-49, impacto severo (IS); 50-70, impacto moderado (IM); y 71-100, impacto discreto o sin impacto (ID/NI). Variables: sexo, edad, días de tratamiento, vivienda en domicilio (D)/residencia(R); indicación de espesante comercial (EC) con MECV-V: néctar (N), miel (M), pudín (P); días con EC, tipo de dieta: puré (DP), blanda (SD), mixta (DM), normal (DN); secciones SWAL-QoL. Resultados: en total, 202 pacientes de 85 años (23-103); IQR: 12. Mayoría de mujeres, 57,9 %; 43,1 % D/56,9 % R. SWAL-QoL: 19,3 % IS, 59,9 % IM y 20,8 % ID/NI. Usar menos espesante demostró mejor QoL, IS en pudín: 21,1 % vs. Néctar: 15,3 %, p = 0,04. Las dietas realizadas fueron: 66,3 % DP; 3 % DB; DM 21,3 %, y DN 9,4 %. En R, más DP (86,1 %) que en D (40,2 %), p < 0,001. DP asociada a peor QoL: % de ID o no impacto en DP, 15,7 % vs. 30,8 % en el resto de dietas, p = 0,016. Analizando cada sección por D/R, diferencia significativa entre miedos, mayor en D (57,01 ± 36,41) vs. R (48,70 ± 27,03), p < 0,001; peor salud mental en R: 66,44 ± 34,30 vs. D: 47,48 ± 24,06, p < 0,001; mejor selección de alimentos en D (75,86 ± 34,12) vs. R (68,17 ± 33,60), p < 0,01. Conclusiones: definir la percepción de la QoL contribuye a una mejor comprensión de las necesidades del paciente. Es necesaria más información para afrontar sus miedos, para adecuar mejor la viscosidad de los líquidos y la textura de la dieta. Se recomienda aumentar la diversidad alimentaria en las residencias.

Evaluación de los hábitos alimentarios relacionados con la ingesta de yodo, el estado nutricional de yodo y disfunción tiroidea en cuatro poblaciones no seleccionadas (proyecto Tirobus) / Assessment of dietary habits related to iodine intake and iodine concentration and thyroid dysfunction in a non-preselected population in Spain (the Thyrobus Project)

Introducción La mayoría de los últimos estudios realizados en España sobre el estado nutricional de yodo muestran una significativa mejoría. Con motivo de una campaña de información sobre la glándula tiroides, la importancia del yodo y el hipotiroidismo, efectuada en 4 ciudades de España, se realizó un estudio para conocer el consumo de alimentos ricos en yodo, la yoduria y la prevalencia de disfunciones tiroideas. Material y métodos Población no seleccionada que acudió a los centros de información de la campaña realizada en Barcelona, A Coruña, Málaga y Madrid. Se realizó una encuesta sobre el consumo de pescado, leche y sal yodada. Se analizó la yoduria (método Pino) y la tirotropina (TSH) (muestra recogida en papel absorbente Whatman-903®).Resultados Se realizaron 872 encuestas (el 40% en Madrid, el 27% en A Coruña, el 19% en Málaga y el 14% en Barcelona). La edad media de la población encuestada era de 51 años (DE: 16) siendo el 81% mujeres. Afirmaba consumir sal yodada el 60,6%; el 90,8% consumía leche diariamente y el 29,3% consumía pescado 3 veces o más por semana. La mediana de yoduria fue de 143,2μg/l. La prevalencia de TSH elevada (>4mUI/l) fue del 1,3% y de TSH baja (<0,4mUI/l) fue del 1,2%.ConclusionesLa mediana de la yoduria global o por ciudades es indicativa de una nutrición óptima de yodo (según criterios de la Organización Mundial de la Salud). Probablemente, productos como la leche y el pescado, además de la sal yodada, pueden haber influido en estos resultados. La prevalencia de hipertiroidismo e hipotiroidismo no conocido detectada es similar a la descrita en otros estudios (AU)

Introduction Most of the studies on urinary iodine levels in Spain in the last decade have reported a significant improvement. A survey was undertaken together with an information campaign on the thyroid gland, the importance of iodine intake and hypothyroidism in four Spanish cities. The goals of the survey were to obtain information on consumption of iodine-containing foods, to measure urinary iodine levels and to evaluate the prevalence of thyroid dysfunction. Materials and methods A non-preselected population attending the information campaign centers located in Barcelona, La Coruña, Malaga and Madrid was studied. A questionnaire on fish, milk and iodized salt consumption was administered. Urinary iodine levels (Pino's method) and thyrotropin (TSH) concentrations (Whatman 903® dry paper method) were measured. Results A total of 872 questionnaires were completed (Madrid 40%; La Coruña 27%; Malaga 19%; and Barcelona 14%). The mean age was 51 years (SD 16); 81% were women. A total of 60.6% of interviewees reported they consumed iodized salt, 90.8% reported daily milk intake and 29.3% reported fish consumption ≥3 times per week. The mean urinary iodine concentration was 143.2μg/L. The prevalence of high TSH levels (>4mUI/L) was 1.3% and that of low TSH levels (<0.4mUI/mL) was 1.2%.Conclusions According to the World Health Organization criteria, the median urinary iodine concentration, both overall or by city, is indicative of optimal iodine intake. In addition to iodized salt intake, consumption of products such as milk and fish has probably contributed to these positive results. The prevalences of undiagnosed hyperthyroidism and hypothyroidism detected in this study were similar to those found in other studies (AU)