Iodine Prophylaxis Research Articles

Ecological aspects of studying the thyroid function of the thyroid gland in women of reproductive age living in a region with iodine deficiency (Akhtynsky district, Republic of Dagestan, Russia)

Aim. To present epidemiological aspects of the study of thyroid function of the thyroid gland.The article presents the results of a clinical and laboratory examination and epidemiological aspects of studying the thyroid function of the thyroid gland in 120 women of reproductive age living in an area with iodine deficiency (Akhtynsky district, Republic of Dagestan – located at an altitude of 1.675 metres above sea level). The women were examined for thyroid diseases and for the presence of intrauterine infections: TORCH toxoplasmosis, ornithosis, rubella, cytomegalo‐ and herpesviruses.All the examined patients had thyroid diseases (the women are registered with an endocrinologist at an Endocrinological Dispensary). All women underwent correction of iodine deficiency in the form of iodine prophylaxis by taking medications containing a daily iodine requirement of up to 250 mcg to normalize thyroid function.Intrauterine infections (IUI) were found in 76 women (69 %. of the patients examined). Intrauterine infections of women registered in the women's clinic of the district hospital were also treated.

Diffuse Enlargement of the Thyroid Gland as a Result of the Impact of Adverse Factors on the Pituitary-thyroid Cystem of Children

The problem of diffuse goiter has attracted the attention of many researchers in recent years. The main reason for the formation of endemic goiter is iodine deficiency in the environment. Epidemiological studies conducted in recent years have shown that almost all regions of Kazakhstan are regions of endemic goiter with natural iodine deficiency. Some of them are characterized by an increase in the severity of endemic goiter. The reasons contributing to the progression of goiter endemicity are the cessation of iodine prophylaxis, the deterioration of the environmental situation and the social situation of a significant part of the population. The purpose of this work was to study the features of thyroid status in children with diffuse goiter. Material and methods There were 38 children under our supervision, 20 (main group) had diffuse (endemic) goiter (5 boys and 15 girls), 18 children (control group) - 5 boys and 13 girls, children in the control group were considered healthy. Results As a result of comparing indicators of the functional state of the pituitary-thyroid system in patients with diffuse goiter, a relatively increased level of thyroid-stimulating hormone is noted, which indicates the negative impact of diffuse goiter on the thyroid status of children. Conclusions As a result of the manifestation of diffuse goiter in children, metabolic disorders of the pituitary-thyroid system occur. Signs of thyroid deficiency are most often observed in children living in iodine-deficient areas. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1213-1218

Recommendations for Protective Actions Based on Projected Public Health Risks Following a Postulated Nuclear Power Plant Accident

This study conducted a regional assessment of the environmental and health consequences due to the release of radionuclides, including the most harmful, such as Cs-137 and I-131, from a hypothetical reactor accident at the first Nuclear Power Plant (NPP), Akkuyu Nuclear Power Plant, in Turkiye under different meteorological conditions. Simulations of the atmospheric flow were done using a Gaussian-based probabilistic model. Based on the estimated air and land contamination, radiation doses and cancer risks to the population were calculated. The assessment results were then compared with the criteria for protective actions in the event of a radioactive release and were subsequently used to assess the sufficiency of the Precautionary Action Zone (PAZ) and Urgent Protective Zone (UPZ) provided by regulations. The assessment indicated that evacuation outside the UPZ would likely be required during the early phase of the emergency, while sheltering indoors might be necessary up to 80 km. Protective actions such as restrictions on being outdoors or iodine prophylaxis are needed far beyond the radius of the UPZ. These results provide important insights into safe protective measures to reduce the risk of radiation-related cancer when considering a hypothetical severe nuclear accident. In addition, the results of this study aim to improve the current nuclear emergency response program and support nuclear decision-making.

Prognostic factors for the development of obstetric and perinatal pathology in pregnant women under conditions of iodine deficiency

According to the World Health Organization (WHO), iodine deficiency is the main cause of mental retardation in children, and at the same time, it significantly affects the pathological course of pregnancy and childbirth. The problem is complicated by the fact that more than 100.000 children with cretinism are born annually in the world. In recent years, there has been a significant increase in endemic thyroid diseases in Ukraine, the main cause of which is insufficient iodine consumption. Iodine deficiency conditions are aggravated by socio‑economic, ecological and radiological factors, while at the same time mass and group iodine prophylaxis is carried out improperly on the state level. Objective. To determine prognostic factors for the development of obstetric and perinatal pathology in pregnant women under conditions of iodine deficiency. Materials and methods. To compile a diagnostic table of prognostic factors of the threat of miscarriage, the analysis has been performed of 185 cases of threatened abortion (111 in the first trimester, 56 in the second, 18 in the third) and 223 control observations (without the threat of miscarriage). A diagnosis was considered as confirmed if it was established using all applicable methods of examination of pregnant women. Results. The risk factors of the occurrence of perinatal pathology include hypothyroxinemia (DC=–2.5) and ioduria in pregnant women less than 100 mg/l (DC=–1.9). In the intranatal period, a negative impact is exerted by the lack of coordination and weakness of labor activity (DC=–8.1). Levels of thyroid‑stimulating hormone (TSH) in umbilical cord blood >10 mIU/ml (DC=–4.6) are the prognostically favorable factors for the postnatal adaptation of the newborn, especially TSH levels >20 mIU/ml (DC=–8.3). Conduction of iodine prophylaxis (DC=7.7) and ioduria in pregnant women 200—400 mg/l (DC=5.1) contribute to the improvement of perinatal outcomes. Conclusions. A retrospective review of the prognostic significance of the diagnostic table in 188 patients with diffuse nontoxic goiter revealed its sensitivity (76%) and specificity (68%). On the basis of the conducted research, we established risk factors for the development of obstetric and perinatal complications, and assessed their informativeness. The developed algorithm is represented by a diagnostic table for the prediction of complications of pregnancy, childbirth and adverse perinatal outcomes in women with endemic thyropathies.

Defining Trimester-Specific Reference Intervals for Thyroid Hormones: Insights from a Bulgarian Monocenter Study.

Background and Objectives: Pregnancy introduces various interfering factors that, alongside individual variations, impact the assessment of thyroid function tests. This underscores the necessity of defining trimester-specific reference intervals for thyroid-stimulating hormone (TSH) levels. Differences in population characteristics, including ethnicity, socio-economic factors, iodine prophylaxis, and obesity, emphasize the need to establish trimester-specific TSH ranges for women of reproductive age in the respective region or center. The aim of the present study was to establish first- and second-trimester-specific reference intervals for TSH and free thyroxine (FT4) in a relevant pregnant population. Materials and Methods: A retrospective monocenter analysis utilized the electronic database of Ob/Gyn Hospital "Dr. Shterev", Sofia, Bulgaria. The analysis involved data from 497 pregnant and 250 non-pregnant women, all without evidence of thyroid dysfunction or a family history thereof, no indication of taking medication interfering with thyroid function, no evidence of levothyroxine treatment, and no history of sterility treatment. To establish the limits of the TSH reference range, the percentile method was applied using a bootstrapping procedure following the recommendations of the International Federation of Clinical Chemistry (IFCC). Results: Trimester-specific reference intervals for TSH and FT4 in our center were established as follows: first trimester-0.38-2.91 mU/L, FT4-12.18-19.48 pmol/L; second trimester-0.72-4.22 mIU/L and 9.64-17.39 pmol/L, respectively. We also established the normal reference range for the non-pregnant control group, which is similar to that applicable in our laboratory. Conclusions: Our results differ from the fixed limits recommended by the American Thyroid Association, European Thyroid Association, and Endocrine Society Guidelines. Following the relevant established intervals would significantly impact timely diagnosis and therapy requirements for a substantial proportion of pregnant women.

The Incidence of malignancy in nodular goiter in endemic and non-endemic regions.

Aim: The purpose of this study is to look into the prevalence of thyroid cancer in Azerbaijan's endemic and non-endemic regions, as well as the effect of unmanaged iodine prophylaxis on the development of thyroid cancer. Material and methods: The study includes 352 patients who were treated operatively for nodular goiter between 2015 and 2022. Patients were separated into two groups based on endemic (n=126) and non-endemic (n=226) regions, as well as two subgroups based on the number of nodules in the thyroid: single nodule (169) and multinodule (183). Thyroid cancer was discovered in 20 patients (15.9%) in the endemic zone (p=0259). Malignancy was found in 11 (8.7%) of single-nodular goiter (SNG) patients and 9 (7.1%) of multi-nodular goiter (MNG) patients (p=0,259): 19 (15.1%) had the classic variation of papillary cancer and 1 (0.8%) had the follicular variant of papillary cancer. Cancer was discovered in 47 cases (20.8%) (p=0.259) in non-endemic regions: malignancy was detected in 23 (10.2%) cases of MNG patients and in -24 (10.6%) of SNG patients. In non-endemic areas, 2 patients (0.7%) had follicular cancer, 36 (15.9%) had the classic type of papillary cancer, 7 (3.1%) had microcarcinoma, and 2 (0.9%) had medullary cancer (p=0,220). Results: Although there was a decrease in the frequency of incidence of goiter disease in general in endemic regions due to the prohibition of iodized table salt, an increase in the frequency of occurrence of MNG (56.4%) was noted. Thyroid malignancy have been identified in 15.9% of endemic nodular goiter patients and 20.8% of non-endemic nodular goiter patients. The significant percentage increase in papillary carcinoma in our region study was consistent with the literature. Conclusions: According to data collected in endemic areas, the use of unregulated iodine prophylaxis resulted in a decrease in the prevalence of follicular carcinoma while increasing the frequency of papillary carcinoma. The prevention of iodized table salt under the conditions of sanitary-epidemiological follow-up under the control according to the endemic characteristics of the regions can lead to a decrease in the risk of follicular cancer

An approach of radiological impact analysis due to a simulated accident of the TRIGA research reactor of Bangladesh

The present study focused on the radiological impact analysis by assessing radiological doses due to a postulated TRIGA Mark-II research reactor accident at AERE, Savar, Dhaka, Bangladesh. Core inventory and source term of radionuclides from different groups such as noble gas, halogen, tellurium, alkali metal, lanthanide, alkaline earth metal, cerium and transition metal were analyzed for 365 days of operation at full power (3 MWth) due to a postulated nuclear accident. The HotSpot code was used for the dose calculation, and the dose values of TED, and Thyroid were calculated for a 40 km radius from the reactor site. Local meteorological data from Bangladesh Meteorological Department were used for the dose assessment and doses were calculated in the three dominant directions such as South, Southeast, and West. The TED and Thyroid dose values are assessed and compared to the PAZs dose criteria of the U.S. Environmental Protection Agency. It is found that doses are higher in stability class F, and evacuation, sheltering, and iodine prophylaxis are needed at longer distances. Since outside of the AERE campus is densely populated, these calculated data may help to ensure radiological safety by taking required protective actions like evacuation, sheltering, and iodine tablet consumption for the same type of accidental situation.

Iodine deficiency and modern possibilities of its prevention in adolescents

Iodine deficiency is one of the most pressing problems of modern healthcare. Currently, there are 21 countries in the world where iodine deficiency in the diet of the population has been proven, but has not yet been eliminated. Russia is one of them due to the lack of a legislative framework for mass iodine prophylaxis in our country. The strategy for the elimination of iodine deficiency diseases on the scale of the Russian Federation is based on the adoption of a federal law providing for the use of iodized salt as a medium. The strategy for the elimination of iodine deficiency diseases on the scale of the Russian Federation is based on the adoption of a federal law providing for the use of iodized salt as a means of population iodine prophylaxis. Currently, less than 30% of the population in Russia consumes iodized salt in their diet, while the target coverage in iodine-rich regions > 90% of households. In 2022, we conducted a survey of 269 adolescents aged 15–17 living in the Saratov Region and found that the share of families who regularly use YS for food was only 24,2%. Most adolescents rarely eat seafood and do not take iodine-containing drugs, which indicates the ineffectiveness of the «voluntary» model of iodine prevention. In the absence of a federal law, the most important step towards solving the problem of combating iodine deficiency diseases should be the formation of a unified nationwide preventive process based on the appropriate regulatory framework in each constituent entity of Russia – the development and implementation of targeted regional programs for the prevention of diseases caused by iodine deficiency.

Hyperthyroidism incidence in a large population-based study in northeastern Italy.

An improvement in iodine status in Veneto Region has been documented in the last decade. We aimed at estimating the incidence of hyperthyroidism in the Veneto Region (Italy) over the period 2013-2022. Retrospective population-based study conducted in Veneto (4.9 million people) using the population registry, an administrative health database. Between 2012 and 2022, hyperthyroidism incidence was defined thank to a health-care co-payment exemption for hyperthyroidism or any hospital diagnosis of hyperthyroidism. Incident hyperthyroidism was defined from 2013 to 2022 to exclude prevalent cases. Standardized incidence rates (IRs) were reported by age, sex, and etiology of thyroid hyperfunction too. We identified 26,602 incident cases (IR of 54.38 per 100,000 person-years, 2.47-fold higher in females than in males). IR decreased from 69.87 (95% CI: 67.49, 72.25) in 2013 to 42.83 (95% CI: 40.99, 44.66) in 2022. In 2020, an out-of-trend decrease in hyperthyroidism incidence was documented, corresponding to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic outbreak, with a realignment to the trend in the subsequent years. The annual percentage change according to the cause of hyperthyroidism was as follows: -6.62% (95% CI: 8.47, 4.73) (P < 0.0001) in toxic multinodular goiter, -7.56% in toxic uninodular goiter (95% CI: 10.54, 4.48) (P < 0.001) and -4.70% (95% CI: 6.33, 3.04) in toxic diffuse goiter (Graves' disease) (P < 0.001). We documented a decline in the incidence of hyperthyroidism in Veneto Region, paralleling the improvement of the iodine status, thanks to a long and sustained iodine prophylaxis campaign. SARS-CoV-2 pandemic and vaccination campaign did not change the declining trend of hyperthyroidism incidence in our study region. An improvement in iodine status in the population residing in the Veneto region has been documented in the last decade, thanks to a nationwide voluntary iodine prophylaxis program running since 2005, but its impact on the epidemiology of thyroid disease has never been documented. This is the largest study on the incidence rates of hyperthyroidism carried out in Italy and covers the longest observation period among all regionwide population-based studies of hyperthyroidism in our country. We documented a reduction in the incidence of hyperthyroidism, which was more pronounced in nodular goiter diagnosis but involved also toxic diffuse goiter. The decline in the incidence of hyperthyroidism in Veneto Region shows the efficacy and safety of the iodine prophylaxis campaign.

Fifteen Years of Iodine Prophylaxis in Italy: Results of a Nationwide Surveillance (Period 2015-2019).

In 2005, a nationwide program of iodine prophylaxis on a voluntary basis was implemented in Italy by law. However, recent data on iodine status are lacking. The aim of this study was to evaluate efficiency, effectiveness, and possible adverse effects (increased occurrence of thyroid autoimmunity and hyperthyroidism) of the Italian iodine prophylaxis program. From 2015 to 2019, a nationwide survey was performed. The use of iodized salt was evaluated in a sample of 164 593 adults and in 998 school canteens. A sample of 4233 schoolchildren (aged 11-13 years) was recruited to assess urinary iodine concentration, prevalence of goiter, and thyroid hypoechogenicity on ultrasound, with the latter being an indirect indicator of thyroid autoimmunity. Neonatal TSH values of 197 677 infants screened in regions representative of Northern, Central, and Southern Italy were analyzed to investigate the percentage of TSH values >5.0 mIU/L. Data on methimazole prescriptions were analyzed as indirect indicators of new cases of hyperthyroidism. The prevalence of the use of iodized salt was 71.5% in adult population and 78% in school canteens. A median urinary iodine concentration of 124 μg/L, a prevalence of goiter of 2.2%, and a prevalence of thyroid hypoechogenicity of 5.7% were observed in schoolchildren. The percentage of neonatal TSH values >5.0 mIU/L resulted still higher (5.1%) than the World Health Organization threshold of 3.0%, whereas the prescriptions of methimazole showed a reduction of 13.5%. Fifteen years of iodine prophylaxis have led to iodine sufficiency in Italy, although there still is concern about iodine nutritional status during pregnancy.

Structural and morphologic characteristics of nodular goiter in chronic iodine deficiency status

OBJECTIVES. Diffuse and nodular goiter are the most common thyroid gland (thyroid) diseases in children and adults living in iodine-deficient regions. Thyroid hormone potentiates progressive hypertrophy and hyperplasia of thyrocytes, with uneven proliferation of thyroid cells leading to nodule formation. Iodine deficiency, which promotes replication of thyroid follicular cells, also increases the incidence of TSH Receptor mutations, leading to receptor activation and autonomous functioning of follicles.AIM. To evaluate and describe ultrasound and cytologic thyroid nodes in the regions in Russia with proven iodine deficiency.MATERIALS AND METHODS. The study was conducted in regions with proven iodine deficiency in the Central and North Caucasian Federal Districts. Population of conditionally healthy adult volunteers (mean age — 47.5 years) was recruited as part of visiting events to screen for the occurrence of thyroid nodes.RESULTS. The results obtained indicate a high prevalence of multinodular colloid goiter in adult patients living in conditions of chronic iodine deficiency. In the Chechen Republic, the prevalence of nodular thyroid pathology was found in 64.5% (205/318) of cases, and in the Tula region — in 40.6% (116/286). In the studied sample the results of cytologic examination confirmed the presence of colloid thyroid masses in 97% (60/62) — Bethesda category II; in 3% (2/62) of patients nodular masses had Bethesda IV. Diffuse goiter prevalence in the examined population was 20.8%.CONCLUSIONS. A study indicates a high prevalence of iodine-deficient thyroid disease — multinodular colloid goiter in regions with proven chronic iodine deficiency. The wide prevalence of goiter with colloid and cystic components is confirmed by the cytologic examination with different ultrasound characteristics according to the EU-TIRADS classification. The obtained data correspond to the official statistics demonstrating high prevalence of nontoxic goiter in adults in the examined regions, which is an important argument confirming the need for systemic iodine prophylaxis.

Priorities of iodine prophylaxis in Ukraine in context of ensuring radiation safety

The current problems were analyzed and the priorities of iodine prophylaxis in Ukraine in the event of a radiation accident at the nuclear power plant in the conditions of Russian military aggression against Ukraine were determined.

Iodine Deficiency and Iodine Prophylaxis: An Overview and Update.

The thyroid gland requires iodine to synthesize thyroid hormones, and iodine deficiency results in the inadequate production of thyroxine and related thyroid, metabolic, developmental, and reproductive disorders. Iodine requirements are higher in infants, children, and during pregnancy and lactation than in adult men and non-pregnant women. Iodine is available in a wide range of foods and water and is susceptible to almost complete gastric and duodenal absorption as an iodide ion. A healthy diet usually provides a daily iodine consumption not exceeding 50% of the recommended intake. Iodine supplementation is usually necessary to prevent iodine deficiency disorders (IDDs), especially in endemic areas. The community-based strategy of iodine fortification in salt has eradicated IDDs, such as endemic goiter and cretinism, in countries providing adequate measures of iodine prophylaxis over several decades in the 20th century. Iodized salt is the cornerstone of iodine prophylaxis in endemic areas, and the continuous monitoring of community iodine intake and its related clinical outcomes is essential. Despite the relevant improvement in clinical outcomes, subclinical iodine deficiency persists even in Western Europe, especially among girls and women, being an issue in certain physiological conditions, such as pregnancy and lactation, and in people consuming unbalanced vegetable-based or salt-restricted diets. Detailed strategies to implement iodine intake (supplementation) could be considered for specific population groups when iodized salt alone is insufficient to provide adequate requirements.

МЕДИКО-САНИТАРНЫЕ ПОСЛЕДСТВИЯ РАДИАЦИОННЫХ АВАРИЙ ПРИ ОБРАЩЕНИИ С ОТРАБОТАННЫМ ЯДЕРНЫМ ТОПЛИВОМ

Purpose: To consider the features of potential health effects for personnel and for the population in the event of radiation accidents at facilities for post-reactor spent nuclear fuel management (including spent nuclear fuel pools and general plant storage facilities, transportation of nuclear materials and their subsequent processing at radiochemical plants). Results: Based on the analysis of publications, the potential radiation consequences for personnel and for the population in the event of various types of radiation accidents at the stages of spent nuclear fuel management were systematized. Conclusion: Advanced technologies underlying the closed nuclear fuel cycle provide a high level of radiation safety for personnel and for the population. At the same time, a large amount of accumulated radioactive and nuclear materials makes it necessary to maintain the health care system in preparedness at all stages of spent nuclear fuel management. Health effects for personnel may be associated with exposure because of criticality accident and internal intake of fission products of uranium and actinides (by inhalation and through wound surfaces). In case of accidents at radiochemical production, combined radiation-thermal and radiation-chemical injuries are also possible. The main potential hazard for the population in the event of radiation accident at the spent nuclear fuel storage facility is the contamination of the environment and exposure to long-lived uranium fission products and actinides. This requires clarification and development of appropriate criteria and derived intervention levels for making decisions on protective measures. Hypothetically, the health effects in case of radiation accident when managing “fresh” spent nuclear fuel can be comparable to a large-scale reactor accident and require urgent protective measures, including evacuation and iodine prophylaxis. An important factor that should also be taken into account when planning health care measures is the need for decontamination of victims.

Prevention of iodine deficiency diseases: focus on regional targeted programs

The strategy for the elimination of diseases associated with iodine deficiency throughout the Russian Federation is based on the adoption of a federal law providing for the use of iodized salt as a means of mass (population) iodine prophylaxis. Chronic iodine deficiency that exists in Russia leads to dramatic consequences: the development of mental and physical retardation in children, cretinism, thyroid diseases, and infertility. Under conditions of iodine deficiency, the risk of radiation-induced thyroid cancer in children in the event of nuclear disasters increases hundreds of times. By definition, all iodine deficiency diseases (IDDs) can be prevented, while changes caused by iodine deficiency during fetal development and in early childhood are irreversible and practically defy treatment and rehabilitation. The actual average consumption of iodine by a resident of Russia is only 40-80 mcg per day, which is 3 times less than theestablished norm (150-250 mcg). Every year, more than 1.5 million adults and 650 thousand children with various thyroid diseases turn to medical institutions. The cause of 65% of cases of thyroid disease in adults and 95% in children is insufficient intake of iodine from the diet. At the stage of preparing the relevant legislative act, the development and implementation of regional programs for the prevention of IDD is of utmost importance. A typical draft of such a program is proposed in this article for its adaptation and use at the regional level.

The effect of sodium restriction on iodine prophylaxis: a review.

Sodium is essential to life. However, its dietary excess is detrimental to the cardiovascular system, and sodium restriction is a crucial step in cardiovascular prevention. Iodine deficiency has been fought worldwide for decades, and substantial success has been achieved introducing the use of iodine-enriched salt. Nevertheless, areas of iodine deficiency persist around the world, both in developing and industrialized countries, and a major concern affecting dietary sodium reduction programs is represented by a possible iodine intake deficiency. There are substantial differences in the source of alimentary iodine among countries, such as iodized salt added, household tap water, seafood, or salt employed in packaged food. It is clear that a sodium-restricted diet can induce differences in terms of iodine intake, depending on the country considered. Moreover, iodine status has undergone relevant changes in many countries in the last years. Systematic review of literature evidence about the possible effects of sodium restriction on population iodine status. To date, the available results are conflicting, depending on country, salt iodization policy, as well as time frame of data collection. However, to ensure an optimal iodine supply by salt fortification, without exceeding the current recommendation by World Health Organization for salt intake, seems to be an achievable goal. A balanced approach may be obtained by an adequate iodine concentration in fortified salt and by promoting the availability of iodized salt for household consumption and food industry use. In this scenario, updated prospective studies are strongly needed.

PROBLEMATIC ASPECTS, COMPLICATIONS, MISCONCEPTIONS AND DEBATABLE ISSUES OF IODINE PROPHYLAXIS IN RADIATION EVENTS (REVIEW).

to consider and review the essence of emergency iodine prophylaxis during radiation events, physiological aspects of iodine metabolism in the body, properties of individual iodine prophylaxis agents that are recommended, and to justify the rationality of using some of them along with absurdity/inadmissibility of others; substantiate the creation of a unified preventive information strategy regarding the event in order to reduce anxiety and other negative psychological consequences among the affected population. The review was performed by searching the abstract and scientometric databases and printed publications. In the event of serious radiation events at nuclear power plants and industry facilities, radioactive iodine is highly likely to enter the environment. With the threat of radioactive iodine incorporation or with its incorporation that has already begun, it is absolutely necessary to carry out the emergency iodine prophylaxis. Such prevention should be carried out with stable iodine preparations such as potassium iodide or potassium iodate in special pharmaceutical formulas. Dosing of drugs in age and population groups should be carried out by specialists in radiation medicine and radiation safety in accordance with internationally recognized guidelines. The use of iodinecontaining food additives, iodine solution for external use and Lugol's solution is categorically unacceptable due to complete ineffectiveness, impracticality of implementation, and sometimes due to the threat of serious harm to health. Clear preparedness plans for possible radiation accidents and incidents, as well as successfullyimplemented appropriate preventive measures, including emergency iodine prophylaxis, are crucial for the effective and successful response to such events. Emergency iodine prophylaxis during radiation events should be carried out exclusively under the guidance of specialists in radiation medicine and radiation safety using special pharmaceutical formulas of potassium iodide or potassium iodate in doses recognized by the international scientific community. Other means of emergency iodine prophylaxis, including «handicraft»/home preparations, are absolutely unacceptable. Implementation of this protective measure should be accompanied by a coordinated information campaign in order to minimize purely radiation risks and to preserve the psychological well-being of the population.

Состояние здоровья организованных детей раннего возраста в зависимости от уровня обеспечения йодом. Возможности коррекции

Insufficient iodine intake is most dangerous during the prenatal stage and in early childhood. Objective. To evaluate the efficacy of iodine deficiency correction in toddlers attending kindergarten. Patients and methods. Efficacy of iodine prophylaxis was analyzed in three stages: 1) in infancy depending on iodine level in breast milk; 2) after one year of age when children started to receive regular food (according to age-specific reference ranges); 3) correction of iodine deficiency in children receiving adapted stage 3 baby formula. Results. We found that smoking, physical inactivity, anemia, and exposure to harmful chemicals had a negative impact on iodine level in the breast milk. Children whose mothers received potassium iodide demonstrated normal coefficient of neuropsychiatric development by their third month of life significantly more often than those whose mothers did not receive potassium iodide (in this group every second infant had some developmental delay). None of the children over 1 year of age who started to receive regular food had severe iodine deficiency. Nutritional correction with adapted stage 3 baby formula in 50 children aged 1 to 3 years ensured positive changes in their health status with a 2-fold decrease in vegetative complaints. Receiving of an adapted stage 3 baby formula increased median urinary iodine excretion from 78 μg/L [34–112] to 113 μg /L [55–174]. Key words: adapted baby formula, toddlers, iodine deficiency, correction, median urinary iodine excretion

Assessment of iodine concentrations of cooking salt commercialized in some municipalities in eastern Algeria.

Introduction. Iodine is a vital element for the thyroid hormones synthesis. Iodine deficiency disorders (IDD) are a major public health problem. In Algeria, iodine prophylaxis has been endowed by an executive decree imposing iodization of food salt. The assessment of the iodine content of cooking salt will contribute to updating the nutritional situation in the region. Objective. The iodine content was evaluated in packed cooking salt, commercialized in twelve municipalities located in East of Algeria. Material and methods. The samples number of 191 divided into 18 salt brands marked "iodized salt" were analyzed by iodometric titration. Results. Iodine content ≥ 15 ppm was noted in 80.7% of the collected salt samples, among which 57.6 % involved excess iodine (&gt; 40 ppm). Iodine content ˂ 15 ppm was observed in 16.7% of the samples displayed insufficient. The non appearance of iodine was perceived in 2.6% of cases, such as in AinFakroun and Meskiana samples which exposed the lowest average concentrations (p&lt;0,001). The minimum and maximum iodine content ranged between 0 ppm and 93 ppm with a median of 46.4 ppm. Conclusion. An increase in the rate of iodized salt samples (≥ 15 ppm) is noted, but in an irregular way between regions. Five municipalities display low iodine contents in salt, thus exposing their populations to increased risk of iodine deficiency, in particular in Meskiana and AïnFakroun. Conversely, another risk that should not be overlooked concerns the overiodized salt. The urgency is to control the quality of salt iodization at all levels, and at the determination of the iodized balance of the populations.

Йодный дефицит: где мы теперь? (Эффективность белорусской стратегии ликвидации йодного дефицита: 15-летний опыт)

Между республиками бывшего СССР, ставшими независимыми государствами, существуют большие различия в состоянии йодной обеспеченности и технологии устранения йодного дефицита в питании населения. В публикации изложена стратегия ликвидации йодной недостаточности, разработанная и внедренная в Республике Беларусь с целью достижения уровня адекватной йодной обеспеченности в государстве. В Республике Беларусь 94 % потребляемой соли составляет йодированная соль, что и обеспечивает адекватное потребление йода, подтверждаемое экскрецией йода с мочой (медиана 169 мкг/л). Продемонстрированная эффективность применяемой в Беларуси модели йодной профилактики, основанной на повсеместном использовании йодированной соли в пищевой промышленности, дает основания рекомендовать эту модель к внедрению в других странах.