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1.
PLoS One ; 15(1): e0227972, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31995589

RESUMO

PURPOSE: The purpose of this study is to evaluate the use of density measurements in the diagnosis of an underlying residual tumor beyond iodine depositions after Lipiodol-based conventional transarterial chemoembolization (cTACE). METHOD AND MATERIALS: Thirty follow-up CT scans of 20 patients 6-12 weeks after Lipiodol-based cTACE, receiving a digital subtraction angiography at the same time, were analyzed. Reference for the detection of a residual tumor was the angiography, and a visible contrast enhancement was categorized as a residual tumor (n = 16 with residual tumor; n = 14 without residual tumor). The density of the iodine depositions was measured in all containing slices in non-contrast-, arterial- and portal venous-phase CT scans, with a slice thickness of 5.00 mm. The mean density of the iodine deposition during the portal venous phase was subtracted from the mean density of the arterial phase to calculate the density changes (a positive enhancement score represents washout in the portal venous phase). In addition, a quotient relating to the non-contrast measurement was evaluated. RESULTS: Patients with a residual tumor displayed significantly higher enhancement scores in favor of density reduction between the arterial and portal venous phases, compared to patients without a residual tumor (1.41 ± 3.59, n = 14 vs. -13.97 ± 2.88, n = 16; p-value < 0.01). Furthermore, 87.75% of patients with an enhancement score higher than -1.00 (n = 9) had a residual tumor, whereas 100.00% of patients with an enhancement score lower than -20.00 (n = 6) were shown to be tumor-free. The enhancement score quotient resulted in similar findings. CONCLUSION: After cTACE in patients with hepatocellular carcinoma (HCC), the presence of a viable tumor correlated with enhancement scores based on the density measurements of iodine depositions in different phases of the CT scan. Low enhancement scores were associated with completely treated tumors and can aid the decision process to avoid possibly unnecessary angiographies.


Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Iodo/isolamento & purificação , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasia Residual/diagnóstico , Angiografia , Artérias/diagnóstico por imagem , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica , Meios de Contraste/administração & dosagem , Meios de Contraste/isolamento & purificação , Óleo Etiodado/administração & dosagem , Feminino , Humanos , Iodo/administração & dosagem , Neoplasias Hepáticas/patologia , Masculino , Neoplasia Residual/diagnóstico por imagem , Neoplasia Residual/patologia , Veia Porta/diagnóstico por imagem , Tomografia Computadorizada por Raios X
2.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(1): 61-69, ene. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-186148

RESUMO

Aunque la nutrición de yodo en España ha mejorado en los últimos años, el problema no está resuelto del todo. Es preciso que las Instituciones sanitarias establezcan medidas para garantizar que la nutrición de yodo de toda la población sea la adecuada, especialmente entre los colectivos de mayor riesgo (niños y adolescentes, mujeres en edad fértil, mujeres embarazadas y madres lactantes). Debe aconsejarse un bajo consumo de sal, pero que esta sea yodada. También es imprescindible que las agencias de control alimentario establezcan un control efectivo sobre una adecuada yodación de la sal. En las futuras encuestas de salud debería incluirse indicadores sobre la nutrición de yodo. El estudio EUthyroid y la Declaración de Cracovia sobre la nutrición de yodo brindan una oportunidad para establecer un plan paneuropeo para la prevención de la deficiencia de yodo que debería ser considerada y aprovechada por las autoridades sanitarias


Although iodine nutrition in Spain has improved in recent years, the problem is not completely resolved. It is necessary that health institutions establish measures to ensure an adequate iodine nutrition of the population, especially among the highest risk groups (children and adolescents, women of childbearing age, pregnant women and nursing mothers). A low salt intake should be advised, but it should be iodized. It is also imperative that food control agencies establish effective control over adequate iodization of salt. Indicators on iodine nutrition should be included in future health surveys. The EUthyroid study and the Krakow Declaration on iodine nutrition provide an opportunity to set up a pan-European plan for the prevention of iodine deficiency that should be considered and used by health authorities


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Compostos de Iodo/uso terapêutico , Deficiência de Iodo/prevenção & controle , Valor Nutritivo , Iodo/administração & dosagem , Iodo/metabolismo , Aleitamento Materno , Dieta Hipossódica , Planejamento em Saúde/legislação & jurisprudência , Sociedades Médicas/legislação & jurisprudência , Sociedades Médicas/normas , Saúde Pública/legislação & jurisprudência , Saúde Pública/normas
3.
Biochem Med (Zagreb) ; 30(1): 010705, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31839725

RESUMO

Introduction: Appropriate iodine intake is important for the entire population, especially in fertile women due to decisive role of thyroid hormones in normal foetal brain development. The aim of this study was to investigate knowledge on iodine role among Croatian women of reproductive age. Materials and methods: The survey was conducted among 378 women of reproductive age during May-September 2018. Data on age, education level, salt intake habits, knowledge of the iodine role and possible presence of thyroid disease were collected and results were presented as numbers or percentage of total number of participants. Comparison between groups was performed by Chi square test. Results: Of 378 participants, 178 reported to be familiar with the iodine role in the body (P = 0.115). Significantly higher proportion of the younger woman and woman with lower degree of education weren't familiar with the iodine role (P < 0.001). More woman were introduced to consequences of insufficient than to excessive iodine intake (273 vs 213; P < 0.001). In addition, participants mainly weren't familiar with obligation of salt iodination (P < 0.001). Presence of thyroid disease was recorded in 75 subjects with higher prevalence in subjects 36-49 years (P < 0.001). Presence of thyroid disease was not associated with knowledge on iodine role on health. Conclusion: Women of reproductive age are not completely aware of the consequences of excessive iodine intake. Thus, further education focusing on more sensitive groups such as woman of younger age should be considered in order to preserve their and their children's health.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Iodo/administração & dosagem , Adolescente , Adulto , Croácia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários , Doenças da Glândula Tireoide/patologia , Adulto Jovem
4.
Ecotoxicol Environ Saf ; 188: 109930, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31727496

RESUMO

BACKGROUND: For the sake of children's health, iodized salt supply has been stopped in many areas with excessive iodine in the drinking water, but children's iodine nutrition status and thyroid function after terminating the iodized salt supply is unknown. Objective We assessed the iodine nutrition, thyroid function and influencing factors for thyroid abnormalities in children from areas with different concentrations of water iodine; the supply of iodized salt has been stopped in high water iodine areas. This study aimed to evaluate whether the strategy of stopping the supplies of iodized salt alone is enough to avoid thyroid dysfunction in all areas with excess water iodine while still meeting the iodine nutrition needs of children. METHODS: A cross-sectional study was conducted in children from four areas with different drinking water iodine concentrations in Tianjin, China. The drinking water samplings and spot urine samples were collected to estimate the external and internal iodine exposure levels. The thyroid volume was measured, and blood samples were collected to assess thyroid function. Logistic regression analysis was used to analyze risk factors for thyroid abnormalities. A dietary survey was conducted to determine the sources of iodine nutrition among the areas with different iodine concentrations in the drinking water. RESULTS: In the area with a drinking water iodine concentration ≥300 µg/L, the median urinary iodine concentration (UIC) in children was 476.30 (332.20-639.30) µg/L, which was higher than that in other groups (all P < 0.05), and the prevalence of thyroid nodules and the thyroid goiter rate were higher than those in the <100 µg/L, 100-150 µg/L and 150-300 µg/L areas (all P < 0.01). Binary logistic regression analysis indicated that the risk of thyroid abnormalities was significantly increased in the UIC 200-299 µg/L group (OR: 4.534; 95% CI: 1.565, 13.135; bootstrapped 95% CI: 1.689, 21.206, P = 0.004) and in the UIC ≥ 300 µg/L group (OR: 6.962; 95% CI: 2.490, 19.460; bootstrapped 95% CI: 2.838, 32.570, P = 0.001) compared to the 100-199 µg/L group. The iodine contribution rates from water in areas with water iodine concentrations ≥300 µg/L are up to 63.04%. CONCLUSIONS: After termination of the iodized salt supply, the level of iodine nutrition of children in the area with drinking water iodine concentrations ≥300 µg/L is still excessive. The water source needs to be replaced in this area. In the area with a water iodine concentration of 150-300 µg/L, it is proposed that stopping the supply of iodized salt is sufficient to achieve the proper iodine nutrition status in children.


Assuntos
Exposição Dietética/análise , Água Potável/química , Bócio/epidemiologia , Iodo/administração & dosagem , Iodo/análise , Cloreto de Sódio na Dieta/administração & dosagem , Cloreto de Sódio na Dieta/análise , Criança , China/epidemiologia , Estudos Transversais , Feminino , Bócio/urina , Humanos , Iodo/urina , Masculino , Estado Nutricional , Prevalência , Fatores de Risco , Cloreto de Sódio na Dieta/urina , Inquéritos e Questionários
5.
Am J Clin Nutr ; 110(1): 102-110, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31788697

RESUMO

BACKGROUND: Milk and dairy products are considered important dietary sources of iodine in many countries. However, to our knowledge, iodine bioavailability from milk has not been directly measured in humans. OBJECTIVE: The aim of this study was to compare iodine bioavailability in iodine-replete adults from: 1) cow milk containing a high concentration of native iodine; 2) milk containing a low concentration of native iodine, with the addition of potassium iodide (KI) to assess a potential matrix effect; and 3) an aqueous solution of KI as a comparator; with all 3 containing equal amounts of total iodine (263 µg/250 mL). We also speciated iodine in milk. DESIGN: We conducted a 3-wk, randomized, crossover balance study in adults (n = 12) consuming directly analyzed, standardized diets. During the 3 test conditions - high intrinsic iodine milk (IIM), extrinsically added iodine in milk (EIM), and aqueous iodine solution (AIS) - subjects collected 24-h urine over 3 d and consumed the test drink on the second day, with 3- or 4-d wash-out periods prior to each treatment. Iodine absorption was calculated as the ratio of urinary iodine excretion (UIE) to total iodine intake. Milk iodine speciation was performed using ion chromatography-mass spectrometry. RESULTS: Iodine intake from the standardized diet was 195 ± 6 µg/d for males and 107 ± 6 µg/d for females; the test drinks provided an additional 263 µg. Eleven subjects completed the protocol. There was a linear relation between iodine intake and UIE (ß = 0.89, SE = 0.04, P < 0.001). There were no significant differences in UIE among the 3 conditions (P = 0.24). Median (range) fractional iodine absorption across the 3 conditions was 91 (51-145), 72 (48-95), and 98 (51-143)% on days 1, 2, and 3, respectively, with day 2 significantly lower compared with days 1 and 3 (P < 0.001). In milk, 80-93% of the total iodine was inorganic iodide. CONCLUSION: Nearly all of the iodine in cow milk is iodide and although fractional iodine absorption from milk decreases with increasing dose, its bioavailability is high. The trial was registered at clinicaltrials.gov as NCT03590431.


Assuntos
Iodo/farmacocinética , Leite/química , Adulto , Animais , Disponibilidade Biológica , Índice de Massa Corporal , Bovinos , Estudos Cross-Over , Dieta , Feminino , Humanos , Iodo/administração & dosagem , Iodo/urina , Masculino , Estado Nutricional , Iodeto de Potássio/administração & dosagem
6.
Medicine (Baltimore) ; 98(45): e17932, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702678

RESUMO

Postoperative infection is one of the most serious complications in orthopedic surgery. We have developed and use iodine-coated implants to prevent and treat postoperative infection in compromised hosts. This study evaluated outcomes using iodine-coated implants for postoperative infections.We treated 72 postoperative infected patients using iodine-coated implants. Of these, 38 were males and 34 were females, with a mean age of 59.3 years. The mean follow-up period was 5.6 years. The patients included 23 with an infection following total knee arthroplasty, 20 following total hip arthroplasty, 11 following osteosynthesis, 11 following spine surgery, 6 following tumor excision, and 1 following osteotomy. Of these, 37 underwent single-stage surgery and 35 underwent staged revision surgery. We performed staged surgery in any case with active infection. The survival of iodine-coated implants was determined using Kaplan-Meier analysis. White blood cell (WBC) and C-reactive protein (CRP) levels were measured pre- and postoperatively. To evaluate the systemic effects of iodine, serum thyroid hormone levels were examined.Five patients underwent re-revision surgery. In 3 patients, periprosthetic infection recurred at an average of 18 months after surgery. The reinfection rate was 4.2%. These patients recovered following reimplantation of iodine-coated prostheses. No patients required amputation. The survival rate of iodine-coated implants was 91%. There were no signs of infection at the latest follow-up. The median WBC level was nearly in the normal range, and CRP levels returned to normal within 4 weeks after surgery. No abnormalities of thyroid gland function were detected.Iodine-coated titanium implants can be very effective in the treatment of postoperative infections. An iodine coating can be safely applied to infected regions.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Materiais Revestidos Biocompatíveis/uso terapêutico , Iodo/administração & dosagem , Procedimentos Ortopédicos/métodos , Infecção da Ferida Cirúrgica/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Reoperação/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
7.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1173-1175, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683409

RESUMO

Iodine nutrition surveillance of vulnerable population was conducted in 18 cities of Henan Province in 2015. The medians and quartiles of urinary iodine concentration in women of reproductive-age (n=3 318), pregnant women (n=36 366), lactating women (n=4 153), infants <2 years of age (n=1 017), and children aged 8-10 years (n=4 806) were 202.1(124.0, 310.0), 192.4(133.6, 262.4), 168.3(119.1, 248.3), 214.2(156.1, 272.3) and 90.0 (121.8, 285.6) µg/L, respectively. Iodine status of the vulnerable populations was generally regarded as adequate in Henan Province. But the median of urinary iodine concentration of reproductive-age women were slightly above the adequate level. The proportions above iodine adequate level were 26.7% in reproductive-age women, 29.4% in pregnant women and 22.5% in children aged 8-10 years.


Assuntos
Iodo/sangue , Iodo/deficiência , Estado Nutricional , Cloreto de Sódio na Dieta/administração & dosagem , Populações Vulneráveis , Adulto , Criança , Pré-Escolar , China , Cidades , Estudos Transversais , Feminino , Humanos , Lactente , Iodo/administração & dosagem , Iodo/uso terapêutico , Lactação , Masculino , Vigilância da População , Gravidez , Cloreto de Sódio na Dieta/uso terapêutico
8.
Medicine (Baltimore) ; 98(41): e17539, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593131

RESUMO

Research on the relationship between iodine intake and thyroid cancer (TC) risk is limited, and the findings are inconclusive. The objective of this study was to provide emerging evidence for the association between iodine intake and TC risk in a Chinese population.An ecological study of epidemiology is used to compare the iodine intake among populations with different TC incidence in Zhoushan, China. Incidence rates of TC were investigated and compared among four counties of the Zhoushan Islands from 2014 to 2018. Iodized salt consumption rate and the level of urinary iodine concentration (UIC) were analyzed for pupils and pregnant women from four counties.During 2014 to 2018, a total of 2495 new cases of TC were diagnosed in Zhoushan Islands. The mean crude incidence rate of TC was 51.29 per 100,000 inhabitants, and the standardized (world population) incidence rate (SIR) was 31.34 per 100,000 population. Incidence rates (SIR and crude incidence rates) were significantly higher in women than in men (χ test, P < .05). Both male and female, the incidence of TC in Daishan County is higher than the other three counties of Zhoushan. Iodized salt consumption rate and median UIC in pupils and pregnant women in Daishan County was significantly lower than the other three counties (χ test and Kruskal-Wallis test, all P < .05). The population with high TC incidence has a lower iodized salt consumption and a lower level of UIC compare with the relative low TC incidence populations.The low consumption of iodized salt with mild iodine deficiency may contribute to explain the exceptionally high incidence of TC in Daishan County. Further subtle designed studies are needed to provide additional insights into the epidemiology and etiology of TC and help identify the safe limit of iodine intake for prevention.


Assuntos
Iodo/efeitos adversos , Neoplasias da Glândula Tireoide/epidemiologia , Adulto , China/epidemiologia , Ecologia , Economia/estatística & dados numéricos , Feminino , Humanos , Incidência , Iodo/administração & dosagem , Iodo/urina , Masculino , Pessoa de Meia-Idade , Gestantes , Cloreto de Sódio na Dieta/administração & dosagem , Cloreto de Sódio na Dieta/efeitos adversos , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/patologia , Oligoelementos/efeitos adversos , Oligoelementos/urina
9.
Nutr Hosp ; 36(Spec No3): 44-48, 2019 Aug 27.
Artigo em Espanhol | MEDLINE | ID: mdl-31368341

RESUMO

Introduction: The importance of a correct diet and nutrition before pregnancy to the end of lactation seems to be without doubt with the scientific information and evidence that we have today. Despite this, recent studies have shown that the mother´s diet is not as adequate as it should be and deficiencies of certain critical nutrients have been detected at this stage. The importance of a correct nutrition of the mother at this stage has already been recognized for decades and today we can affirm that it will affect not only the development of the fetus but also the genetic organization of the future metabolic response of the child and later of the adult. Several recent publications seem to have made clear that they seem to relate maternal nutrition with a possible programming effect related to the appearance of various metabolic alterations in adult life giving rise to the possible appearance of various chronic diseases. For this reason, gestation is going to be a challenge for the mother at the nutritional level due to increase energy and nutrient needs and their relationship to maternal and child health. In the daily diet, milk and milk products are critical sources of nutrients for the correct development of the fetus and the early development of the child. The purpose of this text is to highlight them, to review the effects of conventional dairy products and dairy products fortified with various nutrients on nutritional status during pregnancy and lactation.


Assuntos
Laticínios , Lactação , Fenômenos Fisiológicos da Nutrição Materna , Leite , Necessidades Nutricionais , Adulto , Animais , Aleitamento Materno , Cálcio na Dieta/administração & dosagem , Criança , Saúde da Criança , Fibras na Dieta/administração & dosagem , Ácidos Graxos Ômega-3/administração & dosagem , Feminino , Ácido Fólico/administração & dosagem , Humanos , Iodo/administração & dosagem , Cuidado Pré-Concepcional/métodos , Gravidez
10.
Zhongguo Yi Liao Qi Xie Za Zhi ; 43(4): 275-278, 2019 Jul 30.
Artigo em Chinês | MEDLINE | ID: mdl-31460720

RESUMO

Using three-dimensional printing to produce antibacterial wound dressing is a new topic that will change the production style of wound dressing industry. Combining with post-3D-printed process, a desktop fused deposition molding equipment can be used to produce wound dressing containing polyvinyl alcohol, alginate and chitosan. The wound dressing produced by FDM has good aspects of absorbency, moisture vapour transmission rate and mechanical property. After loaded with antibacterial agent iodine and silver nano particle, the antibacterial activity rate increases to 99% and it is suitable to use as antibacterial wound dressing. This method affects the production of wound dressing to a more cost-effective way, and provides a possible individualized treatment for patient in the future.


Assuntos
Antibacterianos , Bandagens , Impressão Tridimensional , Cicatrização , Alginatos/química , Antibacterianos/administração & dosagem , Bactérias/efeitos dos fármacos , Bandagens/economia , Bandagens/normas , Quitosana/química , Humanos , Iodo/administração & dosagem , Iodo/farmacologia , Nanopartículas/administração & dosagem , Álcool de Polivinil/química , Prata/administração & dosagem , Prata/farmacologia
11.
Nutrients ; 11(7)2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31319484

RESUMO

This study analyzes an oral supplement of molecular iodine (I2), alone and in combination with the neoadjuvant therapy 5-fluorouracil/epirubicin/cyclophosphamide or taxotere/epirubicin (FEC/TE) in women with Early (stage II) and Advanced (stage III) breast cancer. In the Early group, 30 women were treated with I2 (5 mg/day) or placebo (colored water) for 7-35 days before surgery. For the Advanced group, 30 patients received I2 or placebo, along with FEC/TE treatment. After surgery, all patients received FEC/TE + I2 for 170 days. I2 supplementation showed a significant attenuation of the side effects and an absence of tumor chemoresistance. The control, I2, FEC/TE, and FEC/TE + I2 groups exhibited response rates of 0, 33%, 73%, and 100%, respectively, and a pathologic complete response of 18%, and 36% in the last two groups. Five-year disease-free survival rate was significantly higher in patients treated with the I2 supplement before and after surgery compared to those receiving the supplement only after surgery (82% versus 46%). I2-treated tumors exhibit less invasive potential, and significant increases in apoptosis, estrogen receptor expression, and immune cell infiltration. Transcriptomic analysis indicated activation of the antitumoral immune response. The results led us to register a phase III clinical trial to analyze chemotherapy + I2 treatment for advanced breast cancer.


Assuntos
Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Iodo/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/cirurgia , Intervalo Livre de Doença , Feminino , Humanos , Pessoa de Meia-Idade , Terapia Neoadjuvante , Projetos Piloto , Oligoelementos/administração & dosagem
12.
J Comput Assist Tomogr ; 43(4): 612-618, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31268876

RESUMO

OBJECTIVE: The aim of this study was to determine if computed tomography (CT) angiography using an individualized transition delay (CTA-ID) would facilitate reductions in injection rate and iodine dose. METHODS: The CTA-ID was performed in 20 patients with routine injection rate and iodine dose; 20 patients with injection rate lowered by 1 mL/s; and 40 patients with injection rate lowered by 1 mL/s with 29% less iodine. Routine CTAs in the same or size-matched patients served as controls. Diagnostic image quality and intra-arterial CT numbers were assessed. RESULTS: The median transition delay between aortic threshold and CTA-ID image acquisition was significantly longer than with conventional bolus tracking (mean increase, 13.3 seconds; P < 0.0001), with image quality being the same or better. Intra-arterial CT numbers were 200 Hounsfield units or greater for 80 of 80 CTA-ID, but not for 6 of 49 (12%) internal control or for 11 of 80 (14%) size-matched control patients. CONCLUSION: The CTA-ID bolus-tracking software alters transition delays to permit diagnostic CTA examinations despite slower injection rate and less iodine.


Assuntos
Abdome , Aorta/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Meios de Contraste , Iodo , Abdome/irrigação sanguínea , Abdome/diagnóstico por imagem , Idoso , Angiografia por Tomografia Computadorizada/métodos , Angiografia por Tomografia Computadorizada/estatística & dados numéricos , Meios de Contraste/administração & dosagem , Meios de Contraste/uso terapêutico , Humanos , Iodo/administração & dosagem , Iodo/uso terapêutico , Masculino , Radiografia Abdominal , Estudos Retrospectivos , Fatores de Tempo
13.
Arch Endocrinol Metab ; 63(3): 306-311, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31340241

RESUMO

OBJECTIVE: To determine the prevalence of insufficient iodine intake in pregnant women. MATERIALS AND METHODS: The search was performed in the electronic databases Medline (PubMed), Latin American and Caribbean Literature in Health Sciences (Lilacs) and Scopus. Review studies, experimental studies, those with adolescent pregnant women (< 20 years) and iodine supplementation were excluded. The selection followed the steps of identifying the articles in the databases, deleting the duplicates, and reading the titles, abstracts, and then the entire article. The search for the articles occurred in September 2017, using the descriptors "pregnant" and "iodine deficiency" NOT "supplementation" in English, Portuguese and Spanish. RESULTS: Thirteen articles were included, the deficiency prevalence ranged from 16.1% to 84.0%, and the median of iodine intake was insufficient in 75% of the studies. There is no classification for mild, moderate or severe levels of iodine deficiency in pregnant women, which makes it impossible to know the real dimension of the problem. CONCLUSION: The high prevalence of insufficient iodine intake in pregnant women, observed worldwide, shows the need for a population classification in order to direct public policies. Arch Endocrinol Metab. 2019;63(3):306-11.


Assuntos
Saúde Global , Iodo/administração & dosagem , Iodo/deficiência , Feminino , Humanos , Necessidades Nutricionais , Gravidez , Prevalência
14.
Nutrients ; 11(7)2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31323889

RESUMO

The inhabitants of Lazio, similarly to those of other Italian regions, have been historically exposed to the detrimental effects of an inadequate intake of iodine. The latter is a micronutrient essential for the biosynthesis of thyroid hormones (TH). Iodine deficiency is responsible for a number of adverse effects on human health known as iodine deficiency disorders (IDD), the most common of which worldwide are goiter and hypothyroidism. In order to reduce IDD, a national salt iodination program was started in Italy in 2005. In this article we reviewed the available data regarding iodine intake in the Lazio population before and after the introduction of the national salt iodination program, in order to evaluate its efficacy and the eventual problem(s) limiting its success. On the whole, the information acquired indicates that, following the introduction of the program, the dietary iodine intake in the Lazio population is improved. There is, however, still much work ahead to ameliorate the iodine prophylaxis in this region. In fact, although a generally adequate iodine intake in school-age children has been observed, there are still areas where a mild iodine insufficiency is present. Moreover, two independent epidemiological surveys on pregnant women evidenced a low urinary iodine concentration with respect to the reference range conceived by the World Health Organization. These findings demonstrate the need for greater attention to the iodine prophylaxis by health care providers (i.e., obstetricians, gynecologists, pediatricians, etc.), and the implementation of effective advertising campaigns aimed at increasing the knowledge and awareness of the favorable effects of iodine supplementation on population health.


Assuntos
Iodo/deficiência , Iodo/urina , Estado Nutricional , Cloreto de Sódio na Dieta/administração & dosagem , Adolescente , Criança , Feminino , Bócio/epidemiologia , Humanos , Hipotireoidismo/epidemiologia , Hipotireoidismo/prevenção & controle , Iodo/administração & dosagem , Itália/epidemiologia , Masculino , Programas Nacionais de Saúde , Gravidez
15.
PLoS One ; 14(5): e0216931, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150410

RESUMO

Iodine deficiency (ID) during pregnancy results in pregnancy losses, intrauterine growth retardation, and lower IQ in the offspring. Even after two decades of universal salt iodization (USI) implementation, the efficacy of USI has not been reported in high risk groups in vulnerable regions in Ghana. We aimed to assess and improve ID status in childbearing age women (all lactating women) and their toddlers in northern Ghana, a geographically and socioeconomically vulnerable region. We provided weekly supply of household iodized salt and community-based feeding of native Hibiscus Sabdariffaa leaves meal (HSM) prepared with iodized salt to women and their toddlers in intervention (n = 60) vs. control group (n = 60). At baseline, ID was prevalent in women (36%) and their toddlers (29%). For women, both median UIC values for intervention (57.4 ug/l) and control group (65.1 ug/l) were below the recommended UIC value of 100 ug/l with no significant differences between the two groups (p = 0.2778). At the endpoint, median UIC for the intervention group (123.6 ug/l) was significantly higher (p = 0.008) than the control group (59.7 ug/l). Our results suggest that weekly supply of iodized salt along with the feeding HSM is an effective channel for improving iodine status of economically disadvantaged groups in communities remote from coastal lands. Furthermore, our results suggest that decreased median UIC among lactating mothers does not necessarily imply lower iodine status for their breastfed toddlers. And finally, the observed median UIC<100 ug/l may point to a non-improvement in iodine status for the past decade for Ghana. There is a need to revisit, assess, and ascertain the challenges in preventing populations from attaining the intended benefits of the USI policy in Ghana.


Assuntos
Hibiscus/química , Iodo/urina , Medicina Tradicional/métodos , Estado Nutricional , Cloreto de Sódio na Dieta/administração & dosagem , Adulto , Pré-Escolar , Características da Família , Feminino , Gana/epidemiologia , Humanos , Lactente , Iodo/administração & dosagem , Iodo/deficiência , Lactação/fisiologia , Masculino , Folhas de Planta/química , Áreas de Pobreza , Gravidez , Prevalência
16.
Matern Child Nutr ; 15 Suppl 3: e12773, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31148400

RESUMO

Micronutrient deficiencies (including iodine and iron deficiency) is a global health problem affecting one third of the world's population. Salt is an ideal carrier for food fortification as it is universally consumed at equal rates, independently of economic status, and it is industrially processed. Addressing iron and iodine deficiencies together is a challenge, due to interaction between iodine and iron, negating the effect of added iodine. This paper explains the development of an improved microencapsulation-based technology to produce iron premix, which, when added to iodized salt, is stable and organoleptically indistinguishable. Ferrous fumarate was extruded, followed by cutting, sieving to achieve a size of 300-710 µm (salt grain size). Agglomerated extrudates were microencapsulated (5% hydroxypropyl methylcellulose and 5% soy stearin) to form iron premix. Microencapsulation ensures that the added micronutrients are stable without interaction or degradation. Double Fortified Salt is formed by blending iron premix with iodized salt (1:200 ratio). This technology was transferred to India for industrial scale-up. The public distribution system was utilized to establish and monitor an efficient distribution network for DFS in a transparent manner. The scale-up process was initially demonstrated in the state of Uttar Pradesh, following its success two more Indian states have started distribution of DFS. At present, the DFS with iron and iodine is reaching 60 million people in India. This important health intervention technology through food fortification has the potential to be scaled globally to ensure a world free from iron deficiency anemia.


Assuntos
Anemia Ferropriva/prevenção & controle , Composição de Medicamentos/métodos , Compostos Ferrosos/administração & dosagem , Tecnologia de Alimentos/métodos , Alimentos Fortificados , Iodo/administração & dosagem , Cloreto de Sódio na Dieta/administração & dosagem , Oligoelementos/administração & dosagem , Disponibilidade Biológica , Compostos Ferrosos/síntese química , Humanos , Índia/epidemiologia , Ferro/administração & dosagem , Micronutrientes , Cloreto de Sódio na Dieta/síntese química , Oligoelementos/síntese química
17.
Clin Microbiol Infect ; 25(10): 1239-1245, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31238121

RESUMO

OBJECTIVES: Surgical site skin preparation is an effective method to prevent wound complications. The optimal agent has not been established, and guidelines contain conflicting recommendations. METHODS: The aim of alcoholic chlorhexidine or alcoholic iodine skin antisepsis (ACAISA) was to assess the efficacy of surgical site skin preparation with 0.5% chlorhexidine gluconate (w/v) in 70% ethanol (v/v) to 1% iodine (w/v) in 70% ethanol (v/v). This was a cluster randomized, controlled, single-centre, assessor-blinded, superiority trial in patients undergoing elective hip or knee arthroplasty. Each surgeon had a set operating day and the unit of randomization was the day of surgery. The primary outcome was superficial wound complication, defined as a composite endpoint of superficial incisional surgical site infection and/or clinically significant wound ooze in the 30 days following arthroplasty. The secondary outcome was any surgical site infection, including prosthetic joint infection. Outcome ascertainment was undertaken by an independent verification panel. The primary analysis was intention-to-treat, performed at the individual level. Taking into account the clustering effect, analysis of primary and secondary outcomes was undertaken at the level of the surgeon. RESULTS: A total of 780 participants were included; 390 participants were allocated chlorhexidine-alcohol and 390 participants were allocated iodine-alcohol. There was no difference in superficial wound complications: 19 (4.9%) versus 15 (3.8%) respectively (OR 1.28; 95%CI 0.62, 2.63; p 0.50). There was an increased odds of surgical site infection in the chlorhexidine-alcohol group compared to iodine-alcohol: 12 (3.1%) versus four (1.0%) respectively (OR 3.06; 95%CI 1.26, 7.46; p 0.014). The odds of prosthetic joint infection were also increased in the chlorhexidine-alcohol arm compared with iodine-alcohol: seven (1.8%) versus two (0.5%) respectively (OR 3.55; 95%CI 1.20, 10.44; p 0.022). CONCLUSIONS: No difference was observed in the primary outcome of superficial wound complications when chlorhexidine-alcohol and iodine-alcohol were compared. However, on a secondary analysis, iodine-alcohol had greater efficacy than chlorhexidine-alcohol for preventing surgical site infection. CLINICAL TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12614000177651.


Assuntos
Álcoois/administração & dosagem , Clorexidina/administração & dosagem , Desinfetantes/administração & dosagem , Uso de Medicamentos/estatística & dados numéricos , Iodo/administração & dosagem , Cuidados Pré-Operatórios/métodos , Infecção da Ferida Cirúrgica/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Artroplastia/métodos , Austrália , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
18.
Eur J Endocrinol ; 181(3): 255-266, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31252413

RESUMO

Background: Iodine status has long been regarded as an environmental determinant for thyroid dysfunction, but its relationship with thyroid autoimmunity (TAI) is still controversial. Our study aimed to elucidate the relationship between iodine status and TAI through both a population-based study and a dose-response meta-analysis of eligible epidemiological studies. Methods: A population-based, cross-sectional study was firstly carried out, which enrolled a total of 2808 Chinese adults. Odds ratio (OR) with 95% confidence interval (95% CI) was calculated through logistic regression analysis. A dose-response meta-analysis of eligible epidemiological studies was also carried out. Results: The cross-sectional study showed an U-shaped relationship between iodine intake and TAI in adults. Compared with those with more than adequate iodine status, individuals with iodine deficiency, adequate iodine status and iodine excess all had higher risk of TAI, and the adjusted ORs were 1.50 (95% CI 1.03-2.17, P = 0.032), 1.50 (95% CI 1.09-2.07, P = 0.013) and 1.68 (95% CI 1.11-2.53, P = 0.014), respectively. The dose-response meta-analysis included 22 epidemiological studies with a total of 69,987 participants and further validated the U-shaped relationship between iodine intake and TAI in adults, which proved the significantly increased risk of TAI among individuals with either iodine deficiency or iodine excess. Stratified analysis of studies with low risk of confounding bias also identified similar findings. Conclusion: The study suggests an U-shaped relationship between iodine intake and TAI in adults, and both iodine deficiency and iodine excess are risk factors of TAI in adults. The underlying mechanisms need to be elucidated in future studies.


Assuntos
Autoimunidade/fisiologia , Iodo/administração & dosagem , Iodo/sangue , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/tratamento farmacológico , Glândula Tireoide/metabolismo , Adulto , Autoimunidade/efeitos dos fármacos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Doenças da Glândula Tireoide/diagnóstico , Glândula Tireoide/efeitos dos fármacos , Adulto Jovem
19.
Pak J Pharm Sci ; 32(2 (Supplementary)): 859-863, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31103983

RESUMO

To discuss metformin and iv-contrast induced acute renal failure with its reported cases worldwide, associated risk factors and precautions that can be taken to reduce this tragedy & to address this sensitive issue to my technologist family working in clinical situations. As these studies were observational studies and just report contrast induced nephrotoxicity in different countries by analyzing patients data. By Personal experience or by analyzing data available on PACS (Picture archiving and communication system) most commonly available in Hospitals now a days, that is why these studies did not use any scientific procedure. In our study, we collected opinions of Senior Doctors about use of Metformin before and after contrast study. All Doctors were agreed upon investigation of serum creatinine before contrast study. Doctors were not agreed on single opinion but surely they agreed on stop of Metformin before and after procedure. They said its responsibility of imaging technologist or Radiologist to guide patient about this problem. Diabetic patients using Metformin are at high risk of acute renal acidosis if they are undergoing for iodinated contrast study.


Assuntos
Lesão Renal Aguda/induzido quimicamente , Meios de Contraste/administração & dosagem , Creatinina/sangue , Hipoglicemiantes/uso terapêutico , Iodo/administração & dosagem , Metformina/uso terapêutico , Meios de Contraste/efeitos adversos , Diabetes Mellitus/tratamento farmacológico , Interações Medicamentosas , Humanos , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/efeitos adversos , Injeções Intravenosas , Iodo/efeitos adversos , Metformina/administração & dosagem , Metformina/efeitos adversos , Paquistão , Médicos , Guias de Prática Clínica como Assunto
20.
BMC Res Notes ; 12(1): 294, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31133065

RESUMO

OBJECTIVES: Deficiency as well as excess dietary iodine is associated with several thyroid disorders including Grave's disease and goitre. Previously, cross sectional studies conducted among school children in Nepal showed high prevalence of iodine deficiency. In contrast, recently, few studies have revealed emerging trends of excess urinary iodine concentration in children. This paper, reports excess urinary iodine excretion and thyroid dysfunction among school age children from eastern Nepal. RESULTS: It was a community based cross sectional study in which we measured urinary iodine excretion levels among school age children at baseline and after educational program. The educational program consisted of audio-visual and pamphlets on thyroid health. We also screened them for thyroid function status by physical examination and measuring serum thyroid hormones. Our results show that 34.4% of the children had excess urinary iodine concentration above the WHO recommended levels. Overall, 3.2% of the children were identified to have thyroid dysfunction. Urinary iodine concentration was significantly different between types of salt used and between salt iodine content categories.


Assuntos
Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Iodo/urina , Cloreto de Sódio na Dieta/efeitos adversos , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertireoidismo/induzido quimicamente , Hipertireoidismo/metabolismo , Hipertireoidismo/fisiopatologia , Hipotireoidismo/induzido quimicamente , Hipotireoidismo/metabolismo , Hipotireoidismo/fisiopatologia , Iodo/administração & dosagem , Iodo/efeitos adversos , Masculino , Nepal/epidemiologia , Estado Nutricional/fisiologia , Cloreto de Sódio na Dieta/administração & dosagem , Glândula Tireoide/efeitos dos fármacos , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia , Tireotropina/sangue , Tiroxina/sangue
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