Low Iodine Levels Research Articles

Following the footsteps of goiter expeditions in the Urals

Historically, regions with low levels of iodine in soil and water have been associated with a higher prevalence of goiter. The link between iodine deficiency and goiter has led to innovative efforts to address this problem. The article discusses the history of the study of endemic goiter in the Urals, presents the results of a large complex work of goiter expeditions of 1929-1934, thanks to which numerous data were obtained that served as the basis for the organization of therapeutic and mass preventive anti-goiter measures in places where goiter is endemic.

Iodine deficiency hypothyroidism in children in recent years: a re-emerging issue?

Iodine nutrition is a growing issue within the USA due to newer trends of non-iodized salts. There are no recent reviews looking at the current state of iodine deficiency-induced hypothyroidism in children in the USA. We performed a retrospective chart review at our tertiary pediatric endocrine clinic; four met the diagnostic criteria for iodine deficiency defined by a low urine iodine level. We further characterized severity of disease, risk factors, goiter, thyroid labs and antibodies. All cases had significant goiter and were diagnosed within the last 2 years. One case had iodine deficiency due to no iodized salt intake along with concurrent diagnosis of developmental delay and multiple food allergies, while others involved the use of non-iodized salts. Two cases had iodine deficiency along with autoimmunity. It is critical to obtain a dietary history for all patients who present with goiter and/or hypothyroidism. There may be a need to consider reevaluating current preventative measures for iodine deficiency, especially for certain vulnerable populations such as children who do not consume iodized salt. In recent decades, iodine nutrition has become a growing concern due to changing dietary patterns and food manufacturing practices. A dietary history is crucial to obtain in children presenting with hypothyroidism and goiter, especially in children with restrictive diets due to behavioral concerns, developmental delays, or multiple food allergies. Of the 12 different types of salts commercially available, only table salt contains iodine in an appropriate amount; thus, individuals using specialty salts can develop mild to moderate iodine deficiency-related thyroid disease.

СОСТОЯНИЕ ЗНАНИЙ НАСЕЛЕНИЯ О ФАКТОРАХ РИСКА РАЗВИТИЯ ХРОНИЧЕСКИХ НЕИНФЕКЦИОННЫХ ЗАБОЛЕВАНИЙ В ПИЛОТНЫХ РЕГИОНАХ РОССИЙСКОЙ ФЕДЕРАЦИИ

Significance. To date, there is a high prevalence of risk factors and insufficient awareness of their presence among the population. Identification of persons at risk and preventive counseling are the most important goals of public health. Knowledge of the regional profile of risk factors will provide for a targeted development of preventive programs with due regard to the identified features. The purpose of the study was to determine the current state of knowledge about risk factors of chronic non-communicable diseases in the pilot regions of the Russian Federation. Material and methods. A sociological survey was conducted in three pilot regions of the Russian Federation – the Tula Region, the Stavropol Territory and the Republic of Crimea, using a questionnaire. The questionnaire consisted of 33 questions concerning prevention of chronic non-communicable diseases. The sample size equaled to 1,718 respondents. The results were processed in the statistical package SPSS 22.0. Results. Tobacco use, alcohol consumption, high blood sugar (glucose) and high blood pressure had the highest values in the assessment of risk factors. The lowest value was registered for low iodine levels in salt. The results show that the assessment of the impact of a risk factor on own health is significantly lower than abstract knowledge about harmful effects of this risk factor on health. The respondents considered low iodine levels in salt, alcohol consumption, excessive salt intake and smoking to be the least secure risk factors. The study confirms that alcohol consumption is generally considered by the population to be a less significant risk factor than smoking. It is important that only a little more than 20% of the population monitor their blood pressure on a regular basis. Knowledge of the blood glucose (sugar) level is mainly characteristic of women and people over 60 years. Women and people aged 40-59 regularly monitor their sugar intake. Control over this parameter is lower in older people. In relation to the norms of consumption of vegetables and fruit, the female population adheres to a higher level than men, but in general about 60% of the population correctly understand the need to consume an adequate amount of vegetables and fruit. Almost half of the population consider it a necessary norm to walk for at least 1 hour a day. In general, more than 60% of the population believe that they are not well-informed about risk factors. Conclusion. Knowledge about harmful effects of a risk factor does not necessarily result in application of this knowledge in relation to one's own health and behaviour changes. Knowledge about harmful effects of tobacco and alcohol use does not prevent the abuse. The motivation to smoke tobacco cannot be changed only by public awareness campaigns about harmful effects of this risk factor to health. Building awareness should be primarily focused on males. Planning public awareness campaigns, one should pay more attention to rural population. The promotion of iodized salt consumption among all population groups should be strengthened. Scope of application. Developing approaches to raising public awareness regarding prevention of chronic non-communicable diseases at the regional level.

Minerals and Serum Metabolites Profile in Cows Reared on Natural Pastures in a Semi-Arid Area

This study aimed to profile minerals and metabolite levels in cows solely reliant on natural pastures. Mineral plays a significant role in cattle production and reproduction. Measures of serum metabolites are good indicators in disease diagnosis and nutritional status of animals. A total of 179 blood samples were collected from cases of cows of different ages and breeds experiencing dystocia (n=50), downer cow syndrome (n=34), vaginal prolapse (n=16), retained placenta (n=13), and abortions (n=69) following reports submitted to the North-West (NWU) Animal Hospital in Mafikeng Campus. Analysis of minerals and serum metabolite were done using ICP-MSand IDEXX Catalyst Chemistry Analyser. The data were coded and analysed using the Statistical Software for Social Scientists (SPSS) version 25. Descriptive statistics were used to show the distribution of the minerals and serum metabolites levels across the reproductive conditions. The results were significantly different at 5% (P <0.05). Low zinc levels were seen in cows with abortions and dystocia. In downer cow syndrome, the levels of iron, magnesium and phosphorus were high. Low Iodine levels were seen in cows with vaginal prolapse, retained placenta, abortion and dystocia. Low phosphorus levels were noted in cows with vaginal prolapse. Significant differences were seen in the concentrations of Urea/BUN, Total bilirubin, Aspartate amino-transferase (AST), ammonia and lipase. The levels of minerals and serum metabolites are significant indicators in cows presenting with different reproductive conditions and could affect production.

Frequency of Thyroid Cancer in Sonographically and Clinically Isolated Thyroid Nodules in Thyroidectomy Patients

Background: Thyroid nodules are common in areas with low iodine levels, in women, and in patients undergoing neck irradiation. Thyroid nodules can be detected and evaluated using high-resolution ultrasonography (US). US are used to assess the size and characteristics of thyroid nodules, as well as the presence of lymph node metastasis in the neck. It also makes guided fine-needle aspiration possible (US-FNA). Methods: A prospective cross-sectional study carried out at General Hospital, Rangamati during the period from January 2021 to January 2022. Total 87 patients include who were clinically and sonographycally diagnosed as solitary thyroid nodule. Nodules were excluded from this part of the study if images were not available for review. All the patients treated surgically, and histopathological examination carried out. Data were analyzed by standard statistical methods. Results were analyzed by proper test of significance. Results: Females predominated at 64(73.6%), 50(57.5%) had solitary nodules, 79(90.8%) were euthyroid, 29(33.3%) had nodules measuring 1.0-1.9 cm, 13(14.9%) were malignant, and 53(60.9%) underwent hemi-throidectomy. Calcification and intranodular vascularity in ultrasonography findings were statistically significant (p <0.05). Thyroid activity 100% of euthyroid tumors were malignant, while 66 (89.2%) were benign. Conclusion: The incidence of thyroid cancer was discovered to be 14.9% using sonography. Thyroid nodule size has a nonlinear effect on cancer risk. A 2.0 cm threshold is detected, after which cancer risk remains unchanged. All of the euthyroid tumors were malignant.

Disparity between High Iodised Salt Usage and Knowledge of Iodine Nutrition in Pregnancy among Pregnant Women: A Cross-Sectional Study

The micronutrient Iodine is essential throughout life especially during fetal brain development. The deficiency of which is deemed the single most important cause of preventable mental retardation. Iodine Deficiency Disorders (IDD) is manifested in infancy and childhood, which are primarily influenced by low iodine levels in pregnancy. Using iodised salt is a key to ensure elimination of IDD, for which the knowledge and awareness of iodised salt are of prime importance. The study was aimed to determine the knowledge of iodine nutrition and its association with awareness and usage of iodised salt among pregnant women living in eastern UP. Hospital-based cross-sectional study was conducted through random sampling on 200 pregnant women at the regional women’s hospital, Prayagraj, Uttar Pradesh, India. A pre-tested interview schedule was used to assess knowledge. Scores and descriptive statistics were analyzed, bivariate analyses were employed to describe and determine the association among variables. Mean age of respondents was 25.23 ±3.75. The majority of the population belonged to the lower middle (38%) and upper lower class (36%). Nearly half had heard of the nutrient ‘Iodine’ and 37% self-reported usage of iodised salt whereas usage as per brand was 81%. The mean knowledge score was 1.53. Three-fourths of the respondents (74.5%) had a low level of knowledge and a quarter of the respondents (25.5%) had a high level of knowledge. These scores were significantly associated with socioeconomic status, usage of iodised salt (both self-reported and brand used) and with an awareness of iodine as an essential nutrient and its deficiencies (p<0.05). The study shows a significant disparity between knowledge of iodised salt, its use and actual consumption, which can be attributed to successful Universal Salt Iodisation; however, the disparity highlights the need for strategic awareness schemes in women of reproductive age.

A Method for Reducing Variability Across Dual-Energy CT Manufacturers in Quantification of Low Iodine Content Levels.

BACKGROUND. Clinical use of the dual-energy CT (DECT) iodine quantification technique is hindered by between-platform (i.e., across different manufacturers) variability in iodine concentration (IC) values, particularly at low iodine levels. OBJECTIVE. The purpose of this study was to develop in an anthropomorphic phantom a method for reducing between-platform variability in quantification of low iodine content levels using DECT and to evaluate the method's performance in patients undergoing serial clinical DECT examinations on different platforms. METHODS. An anthropomorphic phantom in three body sizes, incorporating varied lesion types and scanning conditions, was imaged with three distinct DECT implementations from different manufacturers at varying radiation exposures. A cross-platform iodine quantification model for correcting between-platform variability at low iodine content was developed using the phantom data. The model was tested in a retrospective series of 30 patients (20 men, 10 women; median age, 62 years) who each underwent three serial contrast-enhanced DECT examinations of the abdomen and pelvis (90 scans total) for routine oncology surveillance using the same three DECT platforms as in the phantom. Estimated accuracy of phantom IC values was summarized using root-mean-square error (RMSE) relative to known IC. Between-platform variability in patients was summarized using root-mean-square deviation (RMSD). RMSE and RMSD were compared between platform-based IC (ICPB) and cross-platform IC (ICCP). ICPB was normalized to aorta and portal vein. RESULTS. In the phantom study, mean RMSE of ICPB across platforms and other experimental conditions was 0.65 ± 0.18 mg I/mL compared with 0.40 ± 0.08 mg I/mL for ICCP (38% decrease in mean RMSE; p < .05). Intrapatient between-platform variability across serial DECT examinations was higher for ICPB than ICCP (RMSD, 97% vs 88%; p < .001). Between-platform variability was not reduced by normalization of ICPB to aorta (RMSD, 97% vs 101%; p = .12) or portal vein (RMSD, 97% vs 97%; p = .81). CONCLUSION. The developed cross-platform method significantly decreased between-platform variability occurring at low iodine content with platform-based DECT iodine quantification. CLINICAL IMPACT. With further validation, the cross-platform method, which has been implemented as a web-based app, may expand clinical use of DECT iodine quantification, yielding meaningful IC values that reflect tissue biologic viability or treatment response in patients who undergo serial examinations on different platforms.

Nutritional Composition of Plant-Based Texture: Modified Foods for Dysphagia Patients

Abstract There are approximately 590 million people in the world with swallowing disorders (dysphagia), who need texture-modified foods to ensure nutritional intake on a daily basis. The aim of this research was to create new texture-modified products and to evaluate their bioactive and mineral compound concentration. Nine new products (five desserts and four puree-soups) were developed from plant-based ingredients with addition of a source of protein, canola oil, ascorbic acid, and other ingredients. Obtained samples were vacuum-cooked, sterilised at 115 °C for 5 min and tested for their bioactive compound concentration (total carotene and phenol concentration, and ABTS and DPPH radical scavenging activity), and concentration of seven vitamins and thirteen minerals important in human nutrition. The obtained data showed that bioactive compound concentration varied from sample to sample, which was expected due to the varied ingredients of each product. Mineral compound concentration analysis showed low levels of iodine, molybdenum, and selenium. The vitamin analysis showed traces of vitamin D3 and low levels of B group vitamins. Overall, the analysed product composition indicated that the natural background of these products is insufficient for ensuring the human body with all of the necessary vitamins and minerals, and the best solution could be the supplementation of these products with complexes of vitamins and minerals.

Abnormal Level of Manganese, Iron, Iodine, and Selenium in the Hair of Children Living in Kashin-Beck Disease Endemic Areas.

Biological geochemistry is a main suggested cause of Kashin-Beck disease (KBD), due to the absence or excess of elements in the environment. Initially, Se deficiency is regarded as the most key role in the etiology of KBD, and selenium supplementation effectively helps to prevent and control KBD. However, several elements are reported to be relevant to KBD or selenium in succession, which indicated selenium deficiency is not the original etiology of KBD. The study comprehensively analyzed the characteristics of the bio-element profile of KBD and further re-examined the unique role of selenium in etiology. The study measured 14 elements, including sodium, potassium, calcium, phosphorus, magnesium, copper, iron, zinc, selenium, iodine, manganese, lead, arsenic, and mercury, which were detected from hair samples collected from 150 boys. Research participants were separated based on whether they had received any preventative treatment (with and without selenium supplementation). From endemic areas, 30 KBD and 30 healthy children without any preventative treatment were selected alongside 30 KBD and 30 healthy children with selenium supplementation. The participants from endemic areas were then compared to 30 healthy children living in non-endemic areas. Compared to the non-endemic group, the levels of iron and manganese were all significantly higher in the endemic groups and were further elevated in KBD participants (p < 0.05). In contrast, selenium and iodine levels in endemic areas were much lower than those of the control group (p < 0.05). The proportions of selenium excess (p < 0.05) and iodine deficiency (p < 0.05) in endemic groups were significantly lower than participants from non-endemic areas. Meanwhile, excess levels of iron (p < 0.05) and manganese (p < 0.05) were higher in the endemic groups. Moreover, the proportions of Zn/Fe and Se/Mn were found to be significantly lower in endemic area participants than those in the control group (p < 0.05). Three pairs of elements had a correlation coefficient value of more than 0.6: 0.7423 for manganese and calcium, 0.6446 for potassium and sodium, and 0.6272 for manganese and iron. The ratios of Se/Mn and Zn/Fe were associated with a correlation coefficient value of 0.8055. Magnesium, sodium, copper, and iodine levels were meticulously examined using binary regression analysis. This was also used to determine the ratios of Ca/Mg, Ca/P, Zn/Fe, Se/Mn, and Se/I. Thus, the study largely revealed the vital role of manganese, iron, and iodine (in conjunction with selenium) in KBD etiology and pathogenesis. High manganese and iron levels with low selenium and iodine levels were identified as characteristic features of the bio-element profile of KBD. The different element ratios reflect the interaction between several elements. The most significant of these were the proportions of Se/Mn and Zn/Fe, which may be significant in the occurrence and development of KBD.

Household Food Security, Nutritional Intake, and Nutritional Status of Pregnant Women in the Central Tapanuli Regency

BACKGROUND: Malnutrition that occurs during pregnancy can result in inadequate household food security so that it will affect the baby to be born. AIM: This study aims to determine household food security, nutrient intake, and nutritional status of pregnant women in the Central Tapanuli Regency. METHODS: This research is part of the DRPM research with the title of improving the nutrition of pregnant women and the success of breastfeeding immediately after birth through strengthening household food security in the Central Tapanuli Regency. The stages of this research are to identify the level of household food security and nutrient intake as well as the nutritional status of pregnant women. The study was conducted using observation and interviews as well as measuring LILA, examination of Hb levels, and iodine levels in the urine of 131 pregnant women purposively in eight districts of the Central Tapanuli. RESULTS: The household food security of status that is food insecure is 18.3%. The nutritional status of pregnant women with anemia was 58.7% and those with SEZ were 19.1% fiber with the low levels of iodine in the urine as much as 63.9%. Adequate intake of energy nutrients is 42% and sufficient protein is 38.9%. There was a significant relationship between food security status and energy intake (p = 0.000; OR = 53.9) and protein intake (p = 0.004; OR = 4.1). CONCLUSIONS: There is a significant relationship between household food security status with energy and protein intake of pregnant women. Increased consumption of foods containing animal protein is recommended for pregnant women related to household food insecurity.

Covid-19 Response: The Importance of Amino Acids, Trace Elements and Polyphenols for Immune Competence

The Covid-19 pandemic is a challenge for both CAM practitioners and CAM users. An adequate immune response is required for both a Covid infection and a Covid vaccination. The adequacy of the immune response depends very much on an individual’s nutritional status. The body users a range of substances to defend itself that require dietary amino acids and trace elements. Free radicals are used to attack microorganisms and antioxidants are used to quelch the free radical activity. Additionally, white blood cells derive 50% of their ATP from glutaminolysis. Glutamine is depleted at high levels of physical activity, including sport, and following burns or operations. A diet low in protein leads to impaired immunocompetence. Unfortunately, a large number of the world population fails to meet the daily requirement of 1.5 to 2.2 g/kg of high-quality protein necessary for good health. This is true even for the elderly in high income countries. Similarly with the trace elements. Large numbers of people live in areas of the world where there are low levels of iodine and selenium in the soil. This results in low levels of these elements in foods procured locally. Other trace elements such as copper, iron and zink are difficult to absorb due to the presence of phytic and oxalic acids in vegetable foods. This is less of a problem for meat eaters as these minerals are found at high levels in meat. In contrast, for vegans and vegetarians whose primary source of protein is grains and pulses, the presence of phytic acid in these foods inhibit absorption of the copper, iron and zinc from plant sources. Women are particularly at risk as their reproductive system requires higher levels of protein, iron and iodine. Ensuring adequate nutrition is the priority for long term immunocompetence.

Insufficient Iodine Level in Urine among Children of a Secondary School: A Descriptive Cross-sectional Study.

Introduction: Iodine deficiency disorders are common endocrinopathies in Nepal. Children are at risk for iodine deficiency disorders. Irreversible mental retardation and brain damage in children are the devastating disorders lead by iodine deficiency. Therefore, the main objective of the study was to find out the prevalence of insufficient iodine level among the children of a secondary school. Methods: This descriptive cross-sectional study was conducted in urine from April 2019 to July 2019 after obtaining ethical approval from Nepal Health Research Council (Registration number: 802/2018). Forty-six urine samples were collected from school children for iodine estimation. Convenience sampling was done. Data were entered into Statistical Package for the Social Science version 21 and descriptive analyses were done. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among the 46 students, majority 36 (78.30%) (95% Confidence Interval= 66.30-90.21) of the school children had insufficient urine iodine level. Among 36 salt samples collected from school children with low urine iodine level, 8 (22.2%) salt samples had iodine less than 15ppm. Conclusions: Iodine estimation revealed a very high percentage of urine samples containing insufficient levels of iodine is similar as compared to studies done in similar settings. Hence, the school children were at risk of iodine deficiency disorders. Iodine deficiency disorders prevention programs should be priority intervention based on available evidence.

Factors associated with inadequate urinary iodine concentration among pregnant women in Mbeya region Tanzania.

Background: Deficient and excess iodine intake during pregnancy can lead to serious health problems. In Tanzania, information available on iodine status during pregnancy is minimal. The aim of this study was to assess the iodine status and its association with sociodemographic factors in pregnant women in the Mbeya region, Tanzania. Method: A cross sectional survey involving 420 pregnant women (n=420) aged between 15-49 years registered in antenatal care clinics was conducted. Data were collected via interviews and laboratory analysis of urinary iodine concentration (UIC). Results: Median UIC was 279.4μg/L (+/-26.1) to 1915μg/L. Insufficient iodine intake (UIC below 150μg/L) was observed in 17.14% of participants, sufficient intake in 24.29% and 58.57% had intakes above the recommended level (&gt;250μg/L). Rungwe district council (DC) had the highest proportion of patients (27.9%) with low iodine levels, while Chunya and Mbarali DCs had the greatest proportion of those with UIC’s, over the WHO recommended level. Fish consumption and education status were associated with increased risk of insufficient iodine while individuals in Mbalali DC aged between 35-49 years were associated with increased risk of UIC above recommended level. Conclusion: Both deficient and excess iodine intake remains a public health problem, especially in pregnant women in Tanzania. Therefore, educational programs on iodine intake are needed to ensure this population has an appropriate iodine intake to prevent any health risks to the mother and the unborn child.

Comparison of Thyroid Hormone Levels between Women Farmers and Non-Farmers in Banten Indonesia.

Pesticides are suspected of being endocrine disruptors. This cross-sectional study measured serum samples for levels of thyroid hormones including thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free T3 (FT3), and free T4 (FT4) among Indonesian female farmers (n = 127) and non-farmers (n = 127). A questionnaire was used to collect information on demographics and risk factors including work characteristics and frequency, and the use of home and agricultural pesticides. Results showed that there were no significant differences in the distribution of the clinical categories of thyroid levels between farmers and non-farmers except for FT3 and T4. However, in multivariable regression controlling for confounders, FT3 and T4 were significantly higher for farmers compared to non-farmers. In addition, 32% of farmers had clinically low iodine levels and 49% of non-farmers had clinically high iodine levels. We conclude that pesticide exposure may not be as important as iodine intake in explaining these findings. We recommend counseling by health workers about the importance of using iodized salt for farmers and counseling about high iodine foods that need to be avoided for non-farmers.

ВОЗМОЖНАЯ РОЛЬ ЭССЕНЦИАЛЬНЫХ ЭЛЕМЕНТОВ В ЭТИОПАТОГЕНЕЗЕ РАССТРОЙСТВ АУТИСТИЧЕСКОГО СПЕКТРА И ЗАДЕРЖКИ ПСИХОРЕЧЕВОГО РАЗВИТИЯ У ДЕТЕЙ РАЗНОГО ВОЗРАСТА

An imbalance of trace elements plays a significant role in the etiopathogenesis of Autism Spec-trum Disorder (ASD) and Speech Development Delay (SDD). The aim of the study was to analyze an essential trace elements content in the hair samples of children with ASD and SDD for better understanding age and gender related diversity. The study included 258 children with ASD and 239 children with SDD. Control group consisted of 620 healthy children of similar age. All children were divided into two age categories (1.5 to 3 years old and 4 to 13 years old). It was shown that girls with ASD had more deviations in hair essential trace elements levels than boys. Children with ASD and SDD (1.5 to 3 years old) had significantly decreased hair iodine level (by 48-58%, p &lt; 0.0001). Low iodine level can be a significant indicator of mental and speech development delay. Normalization of hair iodine level in older boys with ASD accompanied by significant decrease in hair cobalt level (by 24%, p = 0.0001) may reflect age-related characteristics of iodine and cobalt metabolism. Low hair manganese level (by 12-44%, p &lt; 0.05) was observed in all groups of children. It’s possibly associated with decreased manganese excretion from the body and can provoke manganese-induced neurotoxicity. The decrease in copper levels in girls of different ages (by 9-17%, p &lt; 0.01) is probably influenced by hormonal status and earlier onset of puberty.

Tests of the Iodine Level in Food Supplies of the Population in Central Yakutia

Yakutia is an endemic territory for iodine content in the environment. The region of Central Yakutia belongs to the biogeochemical areas known for iodine deficiency. Goiter etiology is associated with low levels of iodine in food. Thus, we analyzed the iodine content in local raw materials (plants, animals, and natural water) in the biogeochemical areas of Central Yakutia. The obtained results show a low amount of iodine in various water sources (river water, lake water, snow water, and rainwater), even in other areas of Yakutia. The iodine content analysis was carried out in food of local origin (beef, horse meat, milk, potatoes, beets, and carrots) as essential food products. Compared to table values, the lowest iodine level was found in milk (3.3 times lower than the standard rate), vegetables (1.7 times lower), and fish (2 times lower). Satisfying values were registered only in meat. The approximate daily iodine intake of a resident has averaged 65.3 mcg, while the standard input is 130–150 mcg/day.

COVID-19 pneumonia: microvascular disease revealed on pulmonary dual-energy computed tomography angiography.

Increased prevalence of acute pulmonary embolism in COVID-19 has been reported in few recent studies. Some works have highlighted pathological changes on lung microvasculature with local pulmonary intravascular coagulopathy that may explain pulmonary artery thrombosis found on pulmonary computed tomography (CT) angiography. The objective of our study was to describe lung perfusion disorders assessed by pulmonary dual-energy CT (DECT) angiography in severe COVID-19 patients. This single center retrospective study included 85 consecutive patients with a reverse transcriptase-polymerase chain reaction diagnosis of SARS-CoV-2 who underwent a pulmonary DECT angiography between March 16th 2020 and April 22th 2020. Pulmonary DECT angiography was performed when the patient had severe clinical symptoms or suffered from active neoplasia or immunosuppression. Two chest radiologists performed pulmonary angiography analysis in search of pulmonary artery thrombosis and a blinded semi quantitative analysis of iodine color maps focusing on the presence of parenchymal ischemia. The lung parenchyma was divided into volumes based on HU values. DECT analysis included lung segmentation, total lungs volume and distribution of lung perfusion assessment. Twenty-nine patients (34%) were diagnosed with pulmonary artery thrombosis, mainly segmental (83%). Semi-quantitative analysis revealed parenchymal ischemia in 68% patients of the overall population, with no significant difference regarding absence or presence of pulmonary artery thrombosis (23 vs. 35, P=0.144). Inter-reader agreement of parenchymal ischemia between reader 1 and 2 was substantial [0.74; interquartile range (IQR): 0.59-0.89]. Volume of ischemia was significantly higher in patients with pulmonary artery thrombosis [29 (IQR, 8-100) vs. 8 (IQR, 0-45) cm3, P=0.041]. Lung parenchyma was divided between normal parenchyma (59%, of which 34% was hypoperfused), ground glass opacities (10%, of which 20% was hypoperfused) and consolidation (31%, of which 10% was hypoperfused). Pulmonary perfusion evaluated by iodine concentration maps shows extreme heterogeneity in COVID-19 patients and lower iodine levels in normal parenchyma. Pulmonary ischemic areas were more frequent and larger in patients with pulmonary artery thrombosis. Pulmonary DECT angiography revealed a significant number of pulmonary ischemic areas even in the absence of visible pulmonary arterial thrombosis. This may reflect microthrombosis associated with COVID-19 pneumonia.

Iodine Content of Salt Use after Years of Universal Iodization Policy and Knowledge on Iodized Salt among Households in the Sissala East Municipality in Upper West Region of Ghana

Background. Iodine deficiency is a global public health concern as it leads to inadequate production of thyroid hormone in the body, causing too many destructive consequences on the roles and functions of different human organs and muscles including brain growth and can manifest into many damaging effects such as intestinal cerebral impedance, cancer of intestine, breast disorders, and physical deformities like goitre and cretinism to one’s body. Despite all these negative effects, there are several important public health programs including universal salt iodization (USI) to improve on households’ iodine intake, notwithstanding this, countless families are still eating foods containing less iodine or no iodine at all. Hence, this study examined the intake of iodized salt after years of universal salt iodization and the knowledge on iodized salt among households in the Sissala East Municipality. Method. A descriptive cross-sectional study was adopted to collect data for the study. Data were collected from women in charge of household meal preparation using a semistructured questionnaire and rapid field iodine test kits. The Statistical Package for Social Sciences (SPSS) version 20 was used for the data analysis and presented in tables and graphs. p value &lt;0.05 was considered as statistically significant. Findings. Only 41.4% of the households have good knowledge on benefits of iodized salt and dangers associated with iodine deficiency. It was realized that the health workers (46.6%) and television were the main sources of information on iodized salt. Household salt usage with adequate (&gt;15 ppm) levels of iodine was 44.0%; however 85.9% of the salts were stored in covered containers. The study showed significant associations between knowledge on iodized salt and educational level (p≤0.001), occupation (p=0.043), religion (p=0.027), and ethnic lineage (p=0.046). Also, the use of iodized salt showed associations with the educational level (p≤0.001), occupation (p=0.003), religion (p=0.042), and knowledge on iodized salt (p≤0.001). Conclusions. Only about 4 in 10 households were consuming salt with adequate iodine, and this coverage is very low compared with the 90% or more coverage recommended by WHO/UNICEF/ICCIDD. Having secondary and tertiary education and having good knowledge of iodized salt has a great influence on the use of iodized salt; however, with this low level of knowledge of importance of iodized salt among women responsible for house food preparations, there is the need for health professionals to intensify education and promotion on iodized salt in the area and to monitor and verify iodine content of salts produced and sold in the market all times, as the source of the salt might have contributed to the low levels of iodine in the household salt.

Patterns of thyroid disorders in Qena population: a hospital-based descriptive study

Background: Data regarding iodine deficiency disorder in Upper Egypt is rare and even limited. In this study, we aim to determine the status of variable patterns of thyroid disorders and find out the relationship between some risk factors like gender, age, family history and the occurrence of thyroid disorders among Qena population referred to our nuclear medicine clinic from January 2011 to the end of December 2012. Methods: A retrospective hospital-based descriptive and analytical study was conducted on patients referred to our nuclear medicine clinic who complained of various clinical features related to the thyroid gland. The study was performed using data collected from the registration unit in the nuclear medicine clinic. Results: A total of 46 patients (9 men and 37 non-pregnant women) were included. The collected variables were sex, age, family history, menstrual status of females, thyroid-related complaints, history of thyroidectomy and I-131 therapy. 43.5% of the patients were highly affected by thyrotoxicosis, followed by hypothyroidism (26.1%), simple nodular goiter (SNG) (17.4%) and differentiated thyroid cancer (DTC) (13%). 80.4% of patients were female and 19.6% were male. The highest number of different thyroid diseases were reported in the age group of 20-49 years. Conclusions: Different risk factors including sex, age, family history are highlighted in this study, but still the low levels of iodine in the soil and drinking water in Upper Egypt and bad nutrition are the most common factors that may cause goiter.

Development of Databases on Iodine in Foods and Dietary Supplements.

Iodine is an essential micronutrient required for normal growth and neurodevelopment; thus, an adequate intake of iodine is particularly important for pregnant and lactating women, and throughout childhood. Low levels of iodine in the soil and groundwater are common in many parts of the world, often leading to diets that are low in iodine. Widespread salt iodization has eradicated severe iodine deficiency, but mild-to-moderate deficiency is still prevalent even in many developed countries. To understand patterns of iodine intake and to develop strategies for improving intake, it is important to characterize all sources of dietary iodine, and national databases on the iodine content of major dietary contributors (including foods, beverages, water, salts, and supplements) provide a key information resource. This paper discusses the importance of well-constructed databases on the iodine content of foods, beverages, and dietary supplements; the availability of iodine databases worldwide; and factors related to variability in iodine content that should be considered when developing such databases. We also describe current efforts in iodine database development in the United States, the use of iodine composition data to develop food fortification policies in New Zealand, and how iodine content databases might be used when considering the iodine intake and status of individuals and populations.