Prevention Of Goiter Research Articles

Evaluation of the nanosize and stability of aqueous dispersions of iodinecontaining conjugates based on carriers of plant origin, promising for iodine enrichment of foods

The high proportion of iodine deficiency diseases in the structure of general morbidity determines the relevance of creating new nontoxic iodine-containing compounds and improving the processes of iodization of foods of mass consumption. In recent years, to solve this problem, a number of iodine-containing compounds based on natural polymers have been proposed, including pectin (iodinepectin), casein (iodine-casein), inulin (iodine-inulin). It seems promising to create iodine-containing conjugates for food industry not only based on natural polymers, which are not individual compounds, but also based on low-molecular plant metabolites that have a high potential for correcting public health. The attention of researchers is attracted, in particular, by the glycosides of Stevia rebaudiana, which have positively proven themselves in the food industry for many years. Current trends in the development of industrial production of iodine-fortified products also include requirements for the compatibility of iodine-containing concentrates with food industry technologies, especially in the formation of time-stable micro-heterogeneous aqueous dispersions. In connection with the above, the purpose of the research was to confirm the formation of an iodine conjugate with a low molecular weight metabolite of Stevia rebaudiana (glycoside rebaudioside A) by infrared (IR) spectroscopy; and to assess the resistance to sedimentation of its aqueous micro-heterogeneous dispersions (iodine-glycoside) comparatively with iodine compounds with natural plant polymeric carriers - pectin (iodine-pectin) and inulin (iodine-inulin) by the method of nanostructural analysis. Material and methods. The IR spectra of the compounds were recorded on a Fourier spectrometer. Measurement of particle sizes in dispersions of iodine-containing substances was carried out on a laser analyzer, wave length 375 nm, in a quartz cuvette (7 ml) after 0, 2, 4, 6, 10, 24, 72 and 144 h. To prepare dispersions, a weighed portion of iodine-pectin (105 mg) was mixed in 100 cm3 of water (600 rpm) at a temperature of 35-40 °C for 60-70 min, weighed portions of iodine-glycoside (120 mg) and iodine-inulin (49.7 mg) were dissolved in 100 cm3 of water at room temperature (23 °C) for 3-4 min. Results. An IR spectroscopy study of the interaction of iodine with rebaudioside A indicated the stabilization of molecular iodine by the functional groups of the glycoside, leading to the formation of a stable iodine-glycoside conjugate. Assessment of the aqueous dispersions of particles of this conjugate by nanostructural analysis showed that the substance iodine-glycoside formed a stable microheterogeneous dispersion with a particle diameter of about 300 nm, which didn't undergo sedimentation during the entire observation period (6 days). Aqueous dispersions of the iodine-inulin with a particle size of 10 nm were comparable with true solutions and remained also stable throughout the entire observation period. Particles of the iodine-containing compound iodine-pectin formed moderately stable aquatic dispersed systems, the time of complete sedimentation of which was 6-10 h. Conclusion. The study of the IR spectra of rebaudioside A and the synthesized sample iodine-glycoside made it possible to confirm the conclusion about the inclusion of iodine molecules in the structure of glycoside molecules. Micro-heterogeneous stable dispersions of this conjugate, as well as iodine-inulin substances, can be convenient concentrates for enriching milk with iodine. Rapid aggregation of particles of iodine-pectin substances in concentrates can prevent their uniform distribution in the target environment, which reduces the effectiveness of industrial technologies for iodine-fortified foods for the mass prevention of endemic goiter.

Safety and Effectiveness of Total versus Subtotal Thyroidectomy in Management of Simple Multinodular Goiter

Abstract Background: Disorders of the thyroid gland constitute the second most common endocrine disease following diabetes mellitus. The prevalence of nodular goiter and thyroid auton-omy is increased in regions with chronic Iodine Deficiency (ID). It has been documented that the thyroid gland adjusts to ID in the early stages by diffuse hyperplasia, while chronic exposure to ID results in nodular hyperplasia, increased colloid content and increased height of the follicular cells. Aim of Study: To compare between total and subtotal thyroidectomy in management of Multinodular Goiter as regard safety and effectiveness and post-operative complica-tions like: Hypocalcaemia, recurrent laryngeal nerve injury and hypoparathyroidism. Material and Methods: This prospective study was done at Ain Shams University Hospitals and Banha teaching hospital during the period between March and September 2019. This study included 40 cases of SMNG. Their age was between 30 to 45 years, consent was taken from each patient pre-operatively. Agreement of ethical committee was done. Results: Our study showed the advantages of total thy-roidectomy include adequate eradication of the disease, prevention of recurrent goiter and avoidance of the need for completion surgery in case of occult malignancy, but it is associated with higher morbidity (postoperative thyroidectomy complications: RLN palsy and hypoparathyroidism) and the need for lifelong replacement therapy (L-thyroxin supplemen-tation). Conclusion: In MNG, there are a high percentage of cases with disease involving the entire gland; many areas of appar-ently healthy tissue are found to be microscopically involved with variable grade of chronic lymphocytic thyroiditis or follicular hyperplasia or even lobular dysplasia with tendency to form nodules. These signs of disease of this organ tend to recurrence if not treated.

Not that simple goiter

The year 2020 marks the centenary of the publication of a classic study by American physicians D. Marine and O. Kimball on the effectiveness of endemic goiter prevention in children in Akron, Ohio. Although goiter has been known from immemorial times, there is still a problem with determining the normal size of the thyroid gland, without which the diagnosis of goiter remains extremely subjective. For example, in Sweden over the past 20 years, not a single case of endemic goiter has been registered, which is not surprising: the country eliminated this pathology decades ago, and the median urinary iodine concentration indicates the optimal iodine intake. Cases of sporadic goiter in children in Sweden are also rare — no more than 6–8 per year. But in Belarus, with the same population (about 10 million), about 2900 cases of goiter in children, both endemic and sporadic, are recorded annually despite the fact that, due to the extensive use of iodized salt since the beginning of the 2000s, there is no iodine deficiency. The incidence of goiter in children, however, having decreased many times over the past 20 years, remains 3 times higher than in Russia, where iodine prophylaxis, if carried out on a limited scale. From the experience of Belarus, Sweden and Russia, we see that the main thing when assessing data on the incidence of goiter and other thyroid diseases associated with iodine deficiency should be not absolute numbers, but the trend of these indicators over the past years. This information should be more actively used by endocrinologists in Russia to assess the effectiveness of preventive measures both at the regional and federal levels.

Research, knowledge, and policy on goitre and iodine inNorway(1850–2016)

Our aim is to shed light on the relationships between research, knowledge, and policy in the case of goitre and the use of iodine as a preventive measure against it in Norway from the 1850s onward. Goitre was previously widespread in certain areas of Norway, but disappeared around 1950. After many decades of silence about goitre and iodine, an expert report in 2016 argued that action should be taken to prevent iodine deficiency. Already in 1927, an international conference on goitre led to the agreement that the best preventive measure against goitre was to fortify table salt with iodine. The conference had Norwegian participants, but Norwegian health authorities did not follow the recommendations from the conference. To understand why new knowledge and recommendations did not result in new policy, we explore the history of Norwegian research on goitre and iodine, and Norwegian contributions to and the inspiration from international research in the field. Furthermore, we analyse the measures for the prevention and curing of goitre that have been implemented by authorities over time. The preventive measures introduced in Norway from the 1930s were very modest and differed from those in other countries. We argue for the importance of analysing the political context to understand the success or failure of advice given by researchers to policymakers.

Selenium, Zinc, and Copper Status in Euthyroid Nodular Goiter: A Cross-Sectional Study.

Background:It is known that some elements are needed for normal thyroid gland functions. Iodine and selenium are the most well-known trace elements necessary for thyroid metabolism. Selenium is involved in the formation of thyroid hormones and the structure of the deiodinases associated with the development of the thyroid gland. While the role of zinc in thyroid metabolism is at the T3 receptor level, the role of copper is yet not clear.Objective:To compare the levels of serum trace elements such as selenium, zinc, and copper between the patients with euthyroid nodular goiter and healthy participants.Methods:This cross-sectional study included 98 patients with euthyroid multinodular goiter and 83 healthy subjects without thyroid disease. The demographics, thyroid hormone levels, and thyroid ultrasonography of the participants were recorded. Venous blood samples were centrifuged and sera samples were stored at -80°C until analysis of selenium, zinc, and copper levels. The levels of trace elements were determined by inductively coupled plasma-mass spectrometry (ICP-MS).Results:While serum, zinc, and selenium levels were significantly higher in the control group than the nodular goiter group, the copper levels were similar in the two groups. Trace elements were not correlated with thyroid hormone levels and thyroid volumes. Patients in the nodular goiter group were analyzed according to their solitary and multiple nodule status. The solitary and multiple nodular goiter groups were similar in terms of copper, zinc, and selenium levels.Conclusions:Deficiency of selenium and zinc may be associated with nodular goiter. Replacement of these trace elements may be useful for the prevention of nodular goiter, especially in deficient regions.

Visible Goiter among Pregnant Women Attending Antenatal Clinic in Public Health Facilities of Debre Markos Town, East Gojjam, North West Ethiopia.

Background Goiter is an abnormal enlargement of the thyroid gland due to inadequate intake of iodine and goitrogenic food. It is the most important public health problem in developing countries like Ethiopia and specifically in East Gojjam. Though there are studies on goiter in Ethiopia, the magnitude is not well known and documented in Debre Markos town on pregnant women. Therefore, this study was carried out to assess the magnitude of visible goiter and associated factors among pregnant women visiting antenatal clinic in three public health facilities of Debre Markos town, North West Ethiopia. Methods Facility-based cross-sectional study was conducted on 401 pregnant women visiting antenatal clinics at three public health facilities using the systematic sampling technique. Data were collected using pretested structured questionnaire by an interview method. All pregnant women were examined for the presence of goiter using World Health Organization (WHO) criteria. Both bivariate and multivariable binary logistic regression analyses were used to see the association between dependent and each independent variable. Result The prevalence of visible goiter was found to be 10.5% (95% CI: 7.5–13.5). Visible goiter was more common in the age category between 15 and 19 years. Low household income (AOR = 4.5, 95% CI: 1.1–18.7), cabbage intake (AOR = 5.2, 95% CI: 1.2–22.3), and poor knowledge about the benefits of iodized salt (AOR = 2.4, 95% CI: 1.1, 5.2) were factors associated with visible goiter. Conclusion and Recommendation Visible goiter is a major public health problem in this study area. Low socioeconomic status, low knowledge of pregnant women about the merits of iodized salt, and frequent intake of goitrogenic foods such as cabbage increase the risk of developing visible goiter. Therefore, due emphasis on goiter prevention and control strategies, increasing knowledge of women on the benefit of iodized salt, including low-income households in safety net programs, and nutritional education on iodine-rich diets (such as tuna, dairy products, and egg) should be emphasized to alleviate the problem.

Knowledge about goitre among female school-going children in Wellega Province, Ethiopia

Background: About 30% of the world population is affected by Iodine Deficiency Disorder and Ethiopia is among the top ten countries in the world with severe iodine deficiency. The objective of this study was to explore the knowledge about goitre and preventive measures among female school children aimed at reducing the occurrence of goitre.Methods: Quantitative, descriptive cross-sectional study design was used to explore the knowledge about goitre among school-going children in three schools in Wellega Province, Ethiopia. Descriptive statistics was used to analyse, organise and interpret the findings.Results: A total of 364 girls aged between 15–19 years participated in the study. Overall, 71.4% did not have the knowledge about goitre, one third (28.6%) knew that goitre is caused by iodine deficiency and less than half (48.4%) knew that iodinated salt prevents occurrence of goitre. Sixty one per cent did not know which local foods aggravate goitre, 35.7% indicated that goitre affects both males and females and a small proportion identified pregnant women, children and adolescents as vulnerable groups for goitre. Only 38% received information about goitre from the schools.Conclusion: The level of knowledge about goitre among school girls in Wellega Province is low. It is recommended that concerted efforts targeting adolescents to acquire knowledge about the causes and prevention of goitre should be made and further studies should be done to explore perceptions and cultural factors that may contribute to the knowledge gap.

STRUCTURE OF THE NODULAR GOITER IN CHILDREN

For today the question of early diagnosis of nosological variants, the method of treatment and prevention of nodular goiter in children is still not fully resolved. There is a few available literature data about study of this problem in children. Objective: to study morphofunctional structure of thyroid nodules in children.The article provides information consisting of the results of a retrospective analysis of case histories of 73 patients, operated with nodular goiter in Z.A. Bashlyaeva Children’sCityClinicalHospital(Moscow) from 2003 to May 2015. The examination included an evaluation of the functional status of the pituitary-thyroid system: there were investigated serum thyroxine, triiodothyronine and thyroid stimulating hor-mone, also was performed thyroid scintigraphy 99mТc. In the postoperative period, there was carried out a final verification of the diagnosis according to the results of the histological conclusion. The histologi-cal type of nodal disease was defined by the WHO classification of 2004. It was established that in the structure of a single-node goiter in children prevail nodular colloid goiter with equal frequency in boys and girls, with the same frequency occurs thyroid adenoma, but more often in girls than in boys. The multinodular goiter equally often detected in girls and boys both nodular goiter colloidal with varying degree of proliferation and colloid in combination with follicular thyroid adenoma. "Hot" nodes in the multinodular goiter are more common than in the single-node goiter and more fre-quently in girls than in boys. The half of children with nodular pathology have "hot" nodes and one out of every three – decompensated form of functional autonomy. Decompensated form of functional autonomy of the thyroid gland in children with "hot" nodes detects regardless of the number of nodes. Papillary thyroid cancer occurs not only in patients with a single-node, but with a multinodular goiter. The results allow to draw conclusions about the heterogeneity of the morphological structure as a single-node and multinodular goiter in children, including papillary thyroid cancer.

Commentary: Epidemiology, iodine deficiency and the power of multidisciplinary sufficiency

It is pleasing to see this article being accorded ‘classic’ status. I am also glad to be able to offer comment on it since, by coincidence, I was ‘on the sidelines’ during the development of several stages of what became a multidisciplinary research-and-intervention odyssey, spanning the 1960s to the 1980s. Around 1970, Basil Hetzel, Foundation Professor of Social and Preventive Medicine at Monash University, Melbourne, Australia—and supervisor of my (unrelated) PhD—saw clearly the need and opportunity to pursue a programme of research for which this classic article is the prime foundation. The programme sought, via epidemiological research and then animal experimental studies, a fuller understanding of the developmental and health consequences of lifelong iodine deficiency. Whereas goitre (sometimes associated with cretinism) had been known to medicine in Europe and China for many centuries, its usual causation by micronutrient deficiency was not understood and neither was its linkage with a wider range of disabilities. Hence the importance of research to achieve, first, the elaboration of the full spectrum of iodine deficiency disorders (IDDs), and, second, the mobilization of international agency support for large-scale population interventions and evaluations. Basil Hetzel was Professor of Medicine during my undergraduate clinical years (1964–66) at the University of Adelaide. I knew nothing, then, of his nascent interest in the problem of iodine deficiency and goitre in the Papua New Guinea (PNG) highlands. In describing the source of his interest, he has noted in his autobiographical book, Chance and Commitment: Memoirs of a Medical Scientist (2005), the role of serendipity in one’s research life—in this case, his being asked to review a journal paper, in 1963, on an exploratory study of goitre prevention in PNG. During my first 2 years in the Department of Social and Preventive Medicine at Monash University, there were occasional frissons of excitement relating to the ongoing randomized controlled trial of cretinism prevention in newborns in a sample of villages in the PNG highlands. The intervention, in 1966, entailed intramuscular injection of reproductive-aged, alternate, women with iodized oil or saline. Follow-up of pregnancy outcome occurred over the next 3 years, via copious boot-leather epidemiology in the mountainous PNG highlands. This classically experimental study was a relatively novel epidemiological research design in the late 1960s—and especially so for non-communicable disease outcomes. (Further, of course, it was carried out at a time when the process of research ethical review was a much lesser source of delay and frustration than is now the case.) Interestingly, at that time, the concepts and terminology of epidemiological research, especially for non-communicable diseases, were in a rather intuitive and unsystematized state. The leading epidemiology textbook of the day, by McMahon and Pugh, did not mention the actual word ‘confounding’. (When I arrived in 1972 at the highly regarded Department of Epidemiology, University of North Carolina, the senior academics there referred to case– control studies as ‘association studies’). Hetzel was fortunate to have able and energetic field-working colleagues, well-attuned to tramping around the PNG highlands—Drs Ian Buttfield and, especially, Peter Pharoah. The support from the PNG Department of Public Health was also invaluable. Meanwhile, back in Australia, the other side of the ‘iodine coin’ was causing public health concern. Tasmania, with its long-standing problem of iodine deficiency and adult goitre, had introduced iodine-supplemented bread in 1966. At that same time, coincidentally, iodine-based sterilizers (iodophors) were introduced into the dairy industry to ensure a safe milk supply. This became a second, unintended, source of iodine supplementation in the diet. A subsequent rise in thyrotoxicosis occurred due to over-exposure to supplementary iodine and, hence, overactive thyroid glands. Hetzel was called in as an advisor. Here was further confirmation of a central role for dietary iodine imbalance as a source of various human health disorders. Published by Oxford University Press on behalf of the International Epidemiological Association

THE RELATIVE POTENCIES OF THYROXINE AND LIOTHYRONINE BY ORAL AND SUBCUTANEOUS ADMINISTRATION IN THE RAT.

Abstract In goitre prevention assays in adult female rats, thyroxine was only one-fifth to one-sixth as active by mouth as by subcutaneous injection whereas liothyronine had about the same biological activity for the two routes of administration. These findings provide an explanation for the fact that thyroxine was one-sixth to one-seventh as active as liothyronine when injected subcutaneously but only one-twentieth to one-thirtieth as potent when the hormones were administered orally. Chemical examination of three commercially available thyroxine samples which were labelled as “chromatographically pure” revealed that one of them contained approximately 10 per cent liothyronine. The presence of this contaminant had a marked influence on the biological responses of the test animals to this preparation.

The biological assay of thyroactive materials by the goitre prevention technique.

Abstract The goitre prevention technique was employed to measure the biological activity of synthetic and natural thyroproteins as well as L-thyroxine and L-triiodothyronine. These studies indicated that L-thyroxine could not be used as a reference standard for natural thyroid preparations since the log dose response lines were not parallel. However, L-thyroxine was a suitable reference standard for the biological assay of the synthetic iodinated proteins

A comparison of the thyroxine: tri-iodothyronine content and biological activity of thyroid from various species.

Abstract Samples of ox and sheep thyroid were less potent than pig thyroid in biological assays when the doses were administered either on the basis of B.P. “Thyroxine-iodine” or U.S.P. total combined iodine. Chemical analyisis for iodothyronines revealed that the molar ratio of thyroxine to tri-iodothyronine approximated 2:1 in pig thyroid but approached 3:1 in ox and sheep preparations. Thus the ox and sheep samples which were less potent in the biological assay than pig thyroid also contained less tri-iodothyronine. By using tri-iodothyronine as the dosage basis, there was very little if any difference in physiological efficacy in goitre prevention assay.

Inhibition of goiter growth and of cyclic AMP formation in rat thyroid by 2-iodohexadecanal

Introduction Thyroid autoregulation has been related to intraglandular content of an unknown putative iodocompound. The thyroid is capable of producing different iodolipids such as 6-iodo-deltalactone (ILδ) and 2-iodohexadecanal (2-IHDA). Data from different laboratories have shown that these iodolipids inhibit several thyroid parameters. ILδ has an antigoitrogenic action but no data about the action of 2-IHDA on this parameter has been published. Objectives to study the action of 2-IHDA on methimazole (MMI)-induced goiter and analyze if this compound can cause the involution of preformed goiter. Results Administration of MMI to rats during 10 days increased thyroid weight by 112%. This effect was significantly inhibited by the simultaneous injection of 20 μg/day of 2-IHDA (51% vs. MMI) while iodine or non iodinated hexadecanal were without action. Thyroidal proliferating cell nuclear antigen (PCNA) content was increased by MMI while 2-IHDA decreased this value (control: 100%; MMI: 190 ± 11; MMI + 2-IHDA: 134 ± 10). Serum TSH was increased after MMI administration and 2-IHDA did not modify this parameter (control: 1.89 ± 0.10; MMI: 8.19 ± 0.93 ng/ml; MMI + 2-IHDA: 7.38 ± 0.72). Treatment with MMI increased thyroidal cAMP content (control: 16.1 ± 0.82, MMI: 42.4 ± 4.6 fmol/mg protein) while injection of 2-IHDA significantly decreased this value (22.3 ± 2.0). Goiter prevention by 2-IHDA was also observed at 30 days of treatment reducing total number of cells (51% inhibition) and epithelial height (81% inhibition). Goiter involution was induced after withdrawal of MMI and injection with 2-IHDA, KI or saline. 2-IHDA led to a reduction of 74.5% in thyroid weight after 3 days while spontaneous involution (saline) was only of 32%. KI failed to alter this value. This significant involution was accompanied by a reduction in the number of cells (66%). Administration of the iodolipids did not produce significant changes in several serum parameters such as total T 3 and T 4, cholesterol, transaminases, urea and creatinine. Conclusion 2-Iodohexadecanal, as 6-iodo-deltalactone, prevents goiter growth in rats and opens a potential therapeutic application of iodolipids.

Urinary Iodide Excretion in Adults in Germany 2005 Meets WHO Target

Recent regional and germanwide investigations have shown that the abolition of the requirement to declare iodine in foodstuffs and the greater emphasis on information about goitre prevention led to an increase in urinary iodine excretion in German schoolchildren. There was also a decrease in thyroid size and goitre prevalence in children. No up to date results in adults for the whole of Germany are available. In 2005 we examined the urinary iodine excretion in the spontaneous morning urine of 1 538 healthy adults in 357 places from all over Germany. The iodine was measured by the Cer- arsenit method. The median iodine excretion amounted to 132 microg/l. There were no significant differences between age groups, sexes or regions. 64% had no iodine deficiency (>100 microg/l). In 23% the deficiency was slight (50-99 microg/l), in 10% moderate (20-49 microg/l) and in 3% there was severe iodine deficiency (<20 microg/l). 29% excreted >200 microg iodide per litre urine. According to the WHO guidelines, there is no longer an iodine deficiency in German adults.

Jodidurie bei Ewachsenen in Deutschland 2005 im WHO-Zielbereich

Recent regional and Germany-wide investigations have shown that the abolition of the requirement to declare iodine in foodstuffs and the greater emphasis on information about goitre prevention led to an increase in urinary iodine excretion in German schoolchildren. There was also a decrease in thyroid size and goitre prevalence in children. No up-to-date results in adults for the whole of Germany are available. In 2005, the authors examined the urinary iodine excretion in the spontaneous morning urine of 1,538 healthy adults in 357 places from all over Germany. The iodine was measured by the cer-arsenite method. The median iodine excretion amounted to 132 microg/l. There were no significant differences between age groups, sexes or regions. 64% had no iodine deficiency (> or = 100 microg/l). In 23% the deficiency was slight (50-99 microg/l), in 10% moderate (20-49 microg/l), and in 3% there was severe iodine deficiency (< 20 microg/l). 29% excreted > 200 microg iodide/l urine. According to the WHO (World Health Organization) guidelines, there is no longer an iodine deficiency in German adults.

The Journal of Laboratory and Clinical Medicine. October, 1917. Volume III, No. 1, Pages 40-49. The prevention of simple goiter in man. A survey of the incidence and types of thyroid enlargements in the schoolgirls of Akron (Ohio), from the 5th to the 12th grades, inclusive-the plan of prevention proposed.

The Prevention of Simple Goiter in Man Get access David Marine, M.D., David Marine, M.D. Search for other works by this author on: Oxford Academic PubMed Google Scholar O. P. Kimball, B.S. O. P. Kimball, B.S. Search for other works by this author on: Oxford Academic PubMed Google Scholar Nutrition Reviews, Volume 33, Issue 9, September 1975, Pages 272–275, https://doi.org/10.1111/j.1753-4887.1975.tb05112.x Published: 01 September 1975

FAKTOR DETERMINAN KEJADIAN GONDOK DI DAERAH PANTAI JAWA TIMUR

The Iodine Deficiency Disorders (IDD) is one of the serious nutritional issues in Indonesia. The survey of IDD in Province of East Java, found that Total Goiter Rate (TGR) in 2003 was higher than 1998 (24.8% and 16.3%) respectively). Iodine deficiency is the main factor of goiter incidence but, there were other factors which could cause the goiter incidence, such as trace element (selenium and zinc) deficiency and exposure of pollutant such as nitrate. The objective of the research is to analyze an association between the trace element andpollutant with the goiter incidence. This research was the cross sectional design, compare goiter and non-goiter respondents. Twenty pupils developing goiter were taken randomly from the goiter population and twenty pupils not suffering of goiter were also taken randomly from the non-goiter population. The median urinary excretion iodine (UEI) levels were higher in the goiter respondents compared with the non-goiter. This might be caused by administration of relatively new iodine capsule to the goiter respondents compared with the non-goiter. The average blood nitrate levels were higher in the in the goiter compared with the non-endemic respondents (575. 75 ± 108.01pg/l :419.45 ± 120.35 pgf I) and there was statistically significant relationship (p &lt; 0.01). According to logistic regression, it can be drawn that the nitrate is determinant factor of coastal area goiter. The goiter prevention program should not be limited to iodine intake, but also include other relevant factors, especially to food and drink nitrate contamination.

Research on Iodine Deficiency and Goiter in the 19th and Early 20th Centuries

In 1811, Courtois noted a violet vapor arising from burning seaweed ash and Gay-Lussac subsequently identified the vapor as iodine, a new element. The Swiss physician Coindet, in 1813, hypothesized the traditional treatment of goiter with seaweed was effective because of its iodine content and successfully treated goitrous patients with iodine. Two decades later, the French chemist Boussingault, working in the Andes Mountains, was the first to advocate prophylaxis with iodine-rich salt to prevent goiter. The French chemist Chatin was the first to publish, in 1851, the hypothesis that iodine deficiency was the cause of goiter. In 1883, Semon suggested myxedema was due to thyroid insufficiency and the link between goiter, myxedema, and iodine was established when, in 1896, Baumann and Roos discovered iodine in the thyroid. In the first 2 decades of the 20th century, pioneering studies by Swiss and American physicians demonstrated the efficacy of iodine prophylaxis in the prevention of goiter and cretinism. Switzerland’s iodized salt program has been operating uninterrupted since 1922. Today, control of the iodine deficiency disorders is an integral part of most national nutrition strategies.

Iodine deficiency in the Federal Republic of Germany. Effectiveness (and risk) of goiter prevention using iodised salt

Iodine deficiency in the Federal Republic of Germany. Effectiveness (and risk) of goiter prevention using iodised salt

Evaluation of goiter using ultrasound criteria: A survey in a middle schoolchildren population of a mountain area in Central Italy

Iodine deficiency is still an important health care problem in the world. In Italy, as in most European countries, it is responsible for the development of mild to moderate endemic goiter. In 1995 we conducted a goiter survey in the Gubbio township, an area of Umbria region in Italy, close to the Appenine mountain chain. This study demonstrated a high prevalence of goiter in the middle schoolchildren population, indicating the presence of moderate endemic goiter. Soon after, a goiter prevention campaign aimed at implementing the consumption of iodinated salt was started. In 2001, a second survey was conducted in the middle schoolchildren (age 11-14 yr old) of Gubbio and neighbour townships. Eight hundred thirteen subjects were studied. Data obtained in 240 age-matched children, studied in the same area in 1995, were used for comparison to monitor changes 5 yr after the beginning of iodine prophylaxis. Thyroid volume was measured by ultrasonography. Gland volume was expressed in ml. A large population living in a iodine-sufficient area, previously reported by others, was used as control. Urinary iodine excretion was measured randomly in 20% of the children. The overall prevalence of goiter decreased between 1995 and 2001 from 29 to 8%. Goiter odds ratio (OR), corrected for age, was 4.0 (95% CI 2.8-5.9) for 1995 compared to 2001 (p<0.000). Mean thyroid volume in the matched populations was 7.6+/-2.5 ml in 1995 and 5.7+/-2.1 ml in 2001. Median iodine urinary excretion increased from 72.6 to 93.5 mug/l, at the limit of statistical significance. Living in a rural area, no consumption of iodized salt and familiarity for goiter represented independent risk factors for goiter development. This study was the first conducted in Umbria region and confirmed that an implementation campaign for iodized salt consumption is a simple and useful instrument to prevent endemic goiter and related diseases. A new survey to evaluate goiter prevalence in the same area 10 yr after the beginning of iodine prophylaxis is already planned.