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Background:The 2016 WHO classification of Tcell acute lymphoblastic leukemia suggest that cases of pre and pro T-cell Acute Lymphoblastic Leukaemia (T-ALL) now fall under Early T-cell precursor ALL (ETP-ALL) or Near ETP-ALL. Accurate subtyping is essential as the subsets are characterized by distinct molecular profiles and identifying molecular aberrations allow patients to receive novel treatment agents. Aim and Objectives: To study the immuno-phenotypic characteristics in T-ALLcases and assess the diagnostic difficulties encountered in its subtyping. Material and Methods: Thirty-seven cases of T-ALL were analysed on flow cytometry using a 6/8 colour panel of monoclonal antibodies, including B cell, T-cell, myeloid and stem cell markers. The cases were categorized as ETP-ALL, near ETP-ALL, cortical T-ALL and medullary T-ALL. Clinical details were retrieved from patient case files. Results: Patient age ranged from 1 to 64 years. Male to female ratio was 2.1: 1 and 35.1% cases were documented to have 3 mediastinal mass. Mean haemoglobin level was 8.6 g/dl, and median total WBC count was 118.3 × 10 /µl. Blast percentage ranged from 39-98%, with mean of 84.8%. On flow cytometry analysis, all cases expressed CD7 and cytoplasmic CD3. CALLA+ (CD10+) were 32.4% cases. The aberrant expression of B-cell marker (CD79a) was observed in 5.4% cases. Majority of the cases were classified as medullary T-ALL, constituting 37.8% cases. ETP-ALL were 21.6% cases, 13.5% cases were near ETP-ALL and 24.3% cases were cortical T-ALL. One case could not be definitely assigned to a specific category. Conclusion: This study reflects the difficulties encountered in subtyping of T-ALLcases due to antigenic overlap and/or due to lack of an extended panel of secondary markers. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the adult iodine nutrition and the prevalence of thyroid diseases in Qinghai Province, and analyze the correlation between iodine and thyroid diseases, so as to provide a basis for adjusting the salt iodization plan in Qinghai Province. Methods: Using cluster and stratified sampling method to select 2628 permanent residents over 18 years old in Qinghai Province for questionnaire survey, physical examination, thyroid color ultrasound, and laboratory index detection. Results: 1. The coverage of iodized salt in adults is 99.71%. 2. The detection rates of thyroid disorders in adults were as follows: Clinical hyperthyroidism was 1.20%, subclinical hyperthyroidism was 0.20%, clinical hypothyroidism was 1.00%, subclinical hypothyroidism was 29.20%, and the goiter was 2.10%. The percentages positivity of TPO Ab, TG Ab, goiter was 9.80%, 9.20%, 2.10%, respectively. Among them single thyroid nodule was 6.40%, multi-nodule thyroid gland was 1.80%. 3. The percentages of mild iodine deficiency, moderate iodine deficiency, Severe iodine deficiency, adequate iodine intake (AI), more than adequate iodine intake (MAI)and excessive iodine intake (EI)were 8.41%, 2.17%, 0.26%, 33.22%, 28.35%, and 27.59%, respectively. The percentages of mild, moderate and severe iodine deficiency in urban populations (7.13%, 0.87%, 0.0%) were significantly lower than those in rural populations (9.81%, 3.59%, 0.56%) (P < 0.05), and the rates of adequate, more than adequate iodine intake in urban populations (36.03%, 30.93%) were significantly higher than that in rural populations (30.14%, 25.52%). The rate of excess iodine intake was higher in rural areas (30.38%) than in urban areas (25.04%). 4. The positive rates of subclinical hypothyroidism, goiter, TPO Ab and TG Ab in female adults (35.28%, 3.39%, 13.54%, 13.94%) were higher than those in male adults (23.58%, 0.96%, 6.266%, 4.79%). The detection rate of single thyroid nodules was higher in urban (8.01%) than rural populations (4.70%), while the detection rate of hypothyroidism, subclinical hypothyroidism, and goiter (0.58%, 25.84%, 1.38%) was lower than that in rural populations (1.52%, 32.96%, 2.96%) (P<0.05). 5. There was no statistical significance in the detection rates of clinical hyperthyroidism, subclinical hypothyroidism, subclinical hypothyroidism, goiter, thyroid nodules, TPO Ab and TG Ab positive rates in different iodine nutritional status (P>0.05). The positive rate of hypothyroidism in the iodine deficiency group is higher than in other iodine nutrition groups. Conclusion: The nutritional status of iodine in Qinghai Province is iodine excess. Subclinical hypothyroidism was detected at a high rate. Subclinical hypothyroidism, goiter, TPO Ab, and TG Ab were more common in female than in male. The proportion of mild, moderate, and severe iodine deficiency was higher in urban areas than in rural areas. The detection rate of thyroid nodules was higher in urban than in rural areas, and that of hypothyroidism, subclinical hypothyroidism, and goiter was lower than that in rural populations. The detection rate of clinical hypothyroidism was statistically significant in different iodine nutritional states (P< 0.05). [ABSTRACT FROM AUTHOR]

Direct iodization in fish sauce, soy sauce, and seasoning sauces plays a crucial role in optimizing the iodine intake of Thailand's people. However, determining the iodine content to ensure that these sauces meet the standard of Thailand's Food and Drug Administration (FDA) is challenging. In this study, all local laboratories equipped with inductively coupled plasma–mass spectrometry (ICP-MS) and with experience in iodine analysis by any analytical method were invited to participate in a hands-on training workshop and two rounds of interlaboratory comparison. The aim was to improve laboratory performance and assess the potential for iodine monitoring for mandatory direct-iodized sauces. All target laboratories participated in this study. The hands-on training workshop harmonized the analytical method and increased the capacity of participating laboratories. Most laboratories (7/8) achieved satisfactory performance for six test samples based on interlaboratory comparison. Samples were extracted by tetramethylammonium hydroxide (TMAH), with the presence of 6% 2-propanol, 0.01% triton X-100, internal standard, and iodine determination in direct-iodized sauces by ICP-MS. The reproducibility standard deviation (SL), after the removal of outlier results for iodine content, was 7–22% iodine at a level of 0.03–4.81 mg/L. Moreover, the Thai FDA's judgment range for official control activities should expand the range of 2–3 mg per 1 L (ppm) by at least 22%. [ABSTRACT FROM AUTHOR]

• Nutrition care should be individualized using clinical data and goals of PwCF. • Consider potential CV complications associated with the legacy, high fat/high calorie CF diet. • FI is a concern in PwCF from all socioeconomic sectors and screening should be part of standard. • There is a lack of data to make specific suggestions about salt intake in those PwCF and hypertension. • Inline enzyme cartridges are effective for digesting nutrients and promoting weight gain in PwCF. To provide interim advice and considerations to the CF Community around CF nutrition in the current era. The Cystic Fibrosis (CF) Foundation organized a multidisciplinary committee to develop a Nutrition Position Paper based on the rapidly changing nutrition landscape in CF, due in part to widespread use of cystic fibrosis transmembrane regulator highly effective modulator therapy (HEMT). Four workgroups were formed: Weight Management, Eating Behavior/Food Insecurity, Salt Homeostasis and Pancreatic Enzyme use. Each workgroup conducted their own focused review of the literature. The committee summarized current understanding of issues pertaining to the four workgroup topics and provided 6 key take-aways around CF Nutrition in the new era. People with CF (pwCF) are living longer, particularly with the advent of HEMT. The traditional high fat, high calorie CF diet may have negative nutritional and cardiovascular consequences as pwCF age. Individuals with CF may have poor diet quality, food insecurity, distorted body image, and an higher incidence of eating disorders. An increase in overweight and obesity may lead to new considerations for nutritional management, given potential effects of overnutrition on pulmonary and cardiometabolic parameters. [ABSTRACT FROM AUTHOR]

BACKGROUND: Gastric cancer (GC) is the fifth most common cancer worldwide and the third leading cause of cancer death. Due to the low rate of early diagnosis, most patients are already in the advanced stage and lose the chance of radical surgery. OBJECTIVE: To investigate the clinical value of computed tomography (CT) dual-energy imaging in preoperative evaluation of pathological types of gastric cancer patients. METHODS: 121 patients with gastric cancer were selected. Dual-energy CT imaging was performed on the patients. The CT values of virtual noncontrast (VNC) images and iodine concentration of the lesion were measured, and the standardized iodine concentration ratio was calculated. The iodine concentration, iodine concentration ratio and CT values of VNC images of different pathological types were analyzed and compared. RESULTS: The iodine concentration and iodine concentration ratio of gastric mucinous carcinoma patients in venous phase and parenchymal phase were lower than those of gastric non-mucinous carcinoma patients, and the differences were statistically significant (P < 0.05). The iodine concentration and iodine concentration ratio of patients with mucinous adenocarcinoma in venous phase and parenchymal phase were lower than those of patients with choriocarcinoma, and the differences were statistically significant (P < 0.05). The iodine concentration and iodine concentration ratio of middle and high differentiated adenocarcinoma patients in venous phase and parenchymal phase were lower than those of low differentiated adenocarcinoma patients, and the differences were statistically significant (P < 0.05). However, there was no significant difference in CT values of VNC images among venous, arterial, and parenchymal phases in all pathological types of gastric cancer patients (P > 0.05). CONCLUSION: Dual-energy CT imaging plays an important role in the preoperative evaluation of patients with gastric cancer. The pathological types of gastric cancer are different, and the iodine concentration will change accordingly. Dual-energy CT imaging can effectively evaluate the pathological types of gastric cancer and has high clinical application value. [ABSTRACT FROM AUTHOR]

Thyroid ultrasound revealed 2.3 cm TR4 mid right nodule, 3.5 cm TR3 lower right thyroid nodule, and 4.7 cm right thyroid nodule that was incompletely visualized extending substernally. POSTER 258 I Thyroid Imaging Case Study Poster i THYROID BED EXTENSION OF THYROID MASS COMPLICATED BY TRACHEAL STENOSIS FROM MASS EFFECT Sakshi Sharma*, K. Romo, Qasim Iqbal Ochsner Clinic Foundation, USA Introduction: A goiter is defined as an enlargement of the thyroid gland regardless of etiology. POSTER 248 WITHDRAWN POSTER 249 I Thyroid Cancer Clinical Poster i IMPACT OF INCOME DISPARITY ON THYROID CANCER SURVIVAL AND SURGERY OUTCOMES: AN ANALYSIS USING... Mohammad Hussein SP 1 sp , Julia McGee* SP 2 sp , Alexandria Luu SP 2 sp , Michelle Tsang SP 2 sp , Manal Malik SP 2 sp , Eman Toraih SP 1 sp , Emad Kandil SP 3 sp SP 1 sp Department of Surgery, Tulane University School of Medicine, USA, SP 2 sp Tulane University School of Medicine, USA, SP 3 sp Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, USA Objective: Although the relationship between disparities and health outcomes of thyroid cancer patients has been studied, less is known about the specific effects of income inequalities on patient outcomes. Strap muscle retracted, swelling was present behind the left lobe of thyroid we dissected and removal done in total CONCLUSION: There are lots of site for dermoid cyst permeation usually in neck in midline But this was typical case presented in thyroid region giving totally looks like thyroid swelling misleading for thyroid diseases. Discussion: This case presents a patient who had previously undergone a right thyroid nodulectomy instead of formal lobectomy and had subsequently developed thyroid extensions outside the thyroid bed complicated by tracheal stenosis from mass effect. [Extracted from the article]

Objective: Researchers have developed the Dietary Inflammatory Index (DII) as a tool to quantify the inflammatory potential of a given diet. Higher DII scores indicated a more proinflammatory diet. While inflammation is known to have a strong impact on thyroid function, the precise nature of the association between DII scores and thyroid function has yet to be clarified. This study was conducted with the goal of exploring this relationship in a representative population of adults from the United States. Methods: For this study, we used data from the National Health and Nutrition Examination Survey (NHANES). Standardized questionnaires were used to collect demographic and dietary data from the participants, and laboratory tests were used to collect data on the participants' thyroid parameters and other relevant data. Linear regression models and smoothed curve fitting were used to assess the relationship between DII scores and thyroid function, with weighted data analyses and subgroup analyses being conducted as appropriate. Results: In total, 7712 subjects were recruited from the NHANES 2007–2012 cohort. Their weighted mean age was 44.87 (0.47) years, mean DII score was 1.41 (0.05). Mean FT3 was 3.20 (0.01) pg/mL and mean TT4 was 7.81 (0.03) µg/dL. In adjusted analyses, higher DII values were related to increases in FT3 (β =.007; p =.027) and TT4 (β =.050; p =.005) levels. Subgroup analyses showed a negative correlation between FT3 levels and DII scores in a population with high urinary iodine concentrations. Conclusion: These data indicate that the consumption of a more proinflammatory diet, as evidenced by elevated DII scores, is correlated with significant increases in FT3 and TT4 levels. However, for people with high urinary iodine concentrations, a more proinflammatory diet was associated with lower FT3 levels. Additional research will be vital to clarify the mechanistic basis for these findings. [ABSTRACT FROM AUTHOR]

Understanding iodine deficiency (ID) burdens and trends in Asia can help guide effective intervention strategies. This study aims to report the incidence, prevalence, and disability-adjusted life years (DALYs) of ID in 48 Asian countries during the period 1990–2019. Data on ID were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 and estimated by age, sex, geographical region, and sociodemographic index (SDI). The estimated annual percentage change (EAPC) was calculated to evaluate the changing trend of age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALYs rate (ASDR) related to ID during the period 1990–2019. In Asia, there were 126,983,965.8 cases with 5,466,213.1 new incidence and 1,765,995.5 DALYs of ID in 2019. Between 1999 and 2019, the EAPC in ASIR, ASPR and ASDR were −0.6 (95% confidence interval [CI], −0.8 to −0.4), −0.9 (95% CI, −1.2 to −0.7), and −1.6 (95% CI, −1.8 to −1.5), respectively. Malaysia charted the largest decrease in ASIR, ASPR, and ASDR (82.4%, 85.3%, and 80.9% separately), whereas the Philippines and Pakistan were the only two countries that witnessed an increase in ASIR and ASPR. ID burdens were more pronounced in women, countries located to the south of the Himalayas, and low-middle SDI regions. The incidence, prevalence, and DALYs of ID in Asia substantially decreased from 1990 to 2019. Women and low-middle SDI countries have relatively high ID burdens. Governments need to pay constant attention to the implementation and monitoring of universal salt iodization. [ABSTRACT FROM AUTHOR]

Introduction: Iodine deficiency disorders (IDD) have remained an unresolved public health problem in India. In this survey, we have estimated the prevalence of IDD among 6-12 years of school children in rural areas of north Karnataka, India and estimated the prevalence of low iodine content (<15 ppm) in salt at the household level and urine iodine excretion in this population. Material and Methods: In this cross-sectional survey, we recruited 16,827 children between 6 and 12 years of age through multistage sampling from six districts. Goitre was examined clinically for all children. Household-level salt iodine estimation and urinary iodine estimation were carried out among a subset of the participants. Results: Overall prevalence of goitre was 17.1% (95% CI: 16.5, 17.7). Out of this, 76.7% (n = 2116) had Grade-1 goitre, and 23.7% (n = 656) had Grade-2 goitre. The prevalence of goitre was higher among females (17.9%, vs. male 16.4%, P < 0.05). The prevalence of low iodine content (<15 ppm) in salt was 48.5% (95%CI: 46.7, 50.3). The overall median iodine excretion in urine was 85 µg/L (IQR: 60-150 µg/L). In total, 37.2% (n = 601) had mild iodine deficiency, 5.2% (n = 84) had moderate deficiency, and 10.1% (n = 163) had severe deficiency. All parameters showed high inter- and intradistrict variations. Conclusion: North Karnataka has a high goitre prevalence. Low use of iodized salt can be a major reason for the high prevalence of the condition. Ensuring the availability of iodized salt in this region and periodic surveillance to measure the impact of the programme should be the priority in this region. [ABSTRACT FROM AUTHOR]

To investigate iodine status and characteristics of breastfeeding women and infants in Zhengzhou after the implementation of the new national standard of iodine in edible salt, so as to provide the basis for formulating prevention and control measures. Urine samples from 28,730 infants aged 0–2 years and 17,977 breastfeeding women who received preventive health care in 12 districts/cities of Zhengzhou from 2012 to 2019 were collected to measure urinary iodine concentration (UIC). A total of 350 pairs of unweaned infants and their mothers were included in this study. After the implementation of the new national standard of iodine in edible salt, the iodine deficiency of infants aged 0–2 years showed a trend of decreasing first and then increasing, but generally the iodine nutrition of infants aged 0–2 years was at the appropriate level in 8 years. There was a gradual decrease in iodine deficiency among breastfeeding women over an 8-year period. And the median UIC of breastfeeding women in 8 years was at iodine nutrition appropriate level. In addition, the UIC of breastfeeding mothers was positively associated with that of infants (r = 0.104, P = 0.004). After the implementation of the new national standard of iodine in edible salt, breastfeeding women and infants in Zhengzhou generally were at an appropriate level of iodine nutrition, and there was a significant positive correlation between the UIC of breastfeeding mothers and infants. [ABSTRACT FROM AUTHOR]

Background: Graves' disease is the most common cause of thyrotoxicosis worldwide. Patient characteristics may vary according to ethnicity, iodine status, and age. Studies on characterization of Graves' disease in Egypt are lacking. The present study aims to report the patient characteristics, as well as treatment preferences and outcomes of Graves' disease patients from Alexandria, Egypt. Methods: A retrospective review of demographic, biochemical, serological, sonographic, and treatment data of Graves' disease patients attending endocrinology outpatient clinic, Alexandria faculty of medicine, Egypt. Results: Three hundred ninety patients were included. Females were 75.9%, peak age was 21–40 years representing 53.1%, and family history of thyroid disease was positive in 60% of patients. Overt hyperthyroidism was present in 93.9%, TSH receptor antibodies were positive in 97.1%, and thyro-peroxidase antibodies in 74.8%. Goiter was present in 72.8%, nodularity in 18.4%, and thyroid eye disease in 17.7%. Medical treatment was used in 90% of patients, surgery in 5.4%, and radioiodine in 4.3%. For patients on medical treatment, 17.7% achieved remission, 29% relapsed, and 2.85% developed hypothyroidism. Conclusion: A typical Graves' disease patient in Egypt is a middle-aged female with a positive family history of thyroid disease. Overt hyperthyroidism was the most common presentation and goiter was a common sign at presentation. The sensitivity of TRAb's for diagnosing Graves' disease was excellent (97.1%). ATD's was the commonest treatment modality with a remission rate of 17.7% and a relapse rate of 29%. [ABSTRACT FROM AUTHOR]

Background: There is no country in the developing world where iodine deficiency is not a public health problem including Ethiopia. Therefore, this study aimed to assess inadequate utilization of iodized salt and associated factors at household level in woreda 11 Nifas Silk Sub-city, Addis Ababa, Ethiopia. Methods: A community-based cross-sectional study was conducted with multistage sampling technique on 348 household respondents. The data were collected using interviewer-administered structured questionnaires and an iodine rapid test kit. The data were edited, cleaned, and entered using Epi-data version 4.6.2 and exported to SPSS version 25 for analysis. A multivariable logistic regression model was fitted to identify associated factors for inadequate utilization of iodized salt. The statistical significance was declared at a p-value of less than 0.05 with 95% confidence interval. Results: A total of 348 household respondents were participated. The amount of iodine content in salt 0 ppm, < 15ppm and > 15ppm were 11.8%, 7.2% and 81.0% respectively. Total inadequate utilization of iodized salt was 19%. Using unpacked salt [AOR; 0.50 (95%CI: 0.27, 0.93)], using a container without a lid [AOR; 0.29 (95%CI: 013, 0.63)], and having insufficient knowledge [AOR; 2.10 (95%CI: 1.14, 3.86)] were all significantly connected with using inadequate iodized salt. Conclusions: Iodized salt utilization was inadequate. Using containers without a lid, unpacked salt, and poor knowledge were associated factors. There should be a provision of adequate knowledge about iodized salt, a proper storage and handling. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to explore application value of iodine concentration from dual-energy spectral computed tomography (DESCT) in preoperative prediction of lymphovascular tumor thrombus in patients with colorectal cancer (CRC). Methods: We finally retrospectively analyzed 50 patients with CRC who underwent abdominal DESCT before receiving any preoperative treatment and underwent surgery to obtain pathological specimens which were stained with hematoxylin-eosin (HE) staining. According to the presence of cancer cell nests in blood vessels and lymphatic vessels, the subjects were divided into the positive group and negative group of lymphovascular tumor thrombus. Two radiologists independently measured the normalized iodine concentration (NIC) values, effective atomic number (Zeff) and CT values of virtual monochromatic images (VMIs) at 40–90 keV of the primary tumors in the arterial phase (AP) and venous phase (VP). Used SPSS 17.0 to calculate the receiver operating characteristic (ROC) curve to evaluate diagnostic value. Results: The patients were divided into lymphovascular tumor thrombus positive group(n = 16) and negative group(n = 34). The values of NIC-AP and NIC-VP in the positive group were 0.17 ± 0.09, 0.51 ± 0.13, respectively. And those in the negative group were 0.15 ± 0.06, 0.43 ± 0.12, respectively. There was significant difference in NIC-VP value between the two groups (p = 0.039), but there was no significant difference in NIC-AP value (p = 0.423). The optimal threshold value of NIC-VP value for diagnosis of lymphovascular tumor thrombus was 0.364. The sensitivity was 68.8% and the specificity was 67.6%. Conclusions: The NIC-VP value of DESCT can be used to predict the presence or absence of the lymphovascular tumor thrombus in CRC patients before operation, which is helpful to select the best treatment scheme and evaluate its prognosis. [ABSTRACT FROM AUTHOR]

Purpose: Iodine deficiency disorder (IDD) is an ongoing worldwide recognized problem with over two billion individuals having insufficient iodine intake. School-aged children and pregnant women are often target groups for epidemiological studies, but there is a lack of knowledge on the general adult population. The aim of this study was to assess the iodine status among a Portuguese public university staff as a proxy for the adult working population. Methods: The population study covered 103 adults within the iMC Salt randomized clinical trial, aged 24–69 years. Urinary iodine concentration was measured spectrophotometrically using the Sandell–Kolthoff reaction. Iodine food intake was assessed using a 24-h dietary recall. The contribution of discretionary salt to the iodine daily intake was assessed through 24-h urinary sodium excretion (UIE) and potentiometric iodine determination of household salt. Results: The mean urine volume in 24 h was 1.5 L. The median daily iodine intake estimated from 24-h UIE was 113 µg/day, being lower among women (p < 0.05). Only 22% of participants showed iodine intake above the WHO-recommended cutoff (150 µg/day). The median daily iodine intake estimated from the 24-h dietary recall was 58 µg/day (51 and 68 µg/day in women and men, respectively). Dairy, including yoghurt and milk products, were the primary dietary iodine source (55%). Iodine intake estimated from 24-h UIE and 24-h dietary recall was moderately correlated (Spearman rank correlation coefficient r = 0.34, p < 0.05). The average iodine concentration in household salt was 14 mg I/kg, with 45% of the samples below the minimum threshold preconized by WHO (15 mg I/kg). The contribution of discretionary salt to the daily iodine intake was around 38%. Conclusion: This study contributes new knowledge about iodine status in Portuguese working adults. The results revealed moderate iodine deficiency, particularly in women. Public health strategies and monitoring programs are needed to ensure iodine adequacy in all population groups. [ABSTRACT FROM AUTHOR]

Purpose: Urinary iodine-to-creatinine ratio (UI/Creat) reflects recent iodine intake but has limitations for assessing habitual intake. Thyroglobulin (Tg) concentration, which increases with thyroid size, appears to be an indicator of longer-term iodine status in children and adults, however, less is known in pregnancy. This study investigated the determinants of serum-Tg in pregnancy and its use as an iodine-status biomarker in settings of iodine-sufficiency and mild-to-moderate deficiency. Methods: Stored blood samples and existing data from pregnant women from the Netherlands-based Generation R (iodine-sufficient) and the Spain-based INMA (mildly-to-moderately iodine-deficient) cohorts were used. Serum-Tg and iodine status (as spot-urine UI/Creat) were measured at median 13 gestational weeks. Using regression models, maternal socio-demographics, diet and iodine-supplement use were investigated as determinants of serum-Tg, as well as the association between UI/Creat and serum-Tg. Results: Median serum-Tg was 11.1 ng/ml in Generation R (n = 3548) and 11.5 ng/ml in INMA (n = 1168). When using 150 µg/g threshold for iodine deficiency, serum-Tg was higher in women with UI/Creat < 150 vs ≥ 150 µg/g (Generation R, 12.0 vs 10.4 ng/ml, P = 0.010; INMA, 12.8 vs 10.4 ng/ml, P < 0.001); after confounder adjustment, serum-Tg was still higher when UI/Creat < 150 µg/g (regression coefficients: Generation R, B = 0.111, P = 0.050; INMA, B = 0.157, P = 0.010). Iodine-supplement use and milk intake were negatively associated with serum-Tg, whereas smoking was positively associated. Conclusion: The association between iodine status and serum-Tg was stronger in the iodine-deficient cohort, than in the iodine-sufficient cohort. Serum-Tg might be a complementary (to UI/Creat) biomarker of iodine status in pregnancy but further evidence is needed. [ABSTRACT FROM AUTHOR]

Objective: Pregnant and lactating women are particularly at higher risk of iodine deficiency due to their increased iodine requirements. Iodine is necessary for normal growth and brain development. In regions with moderate iodine deficiency, such as Turkey, the fate of newborn babies is a critical issue.This study evaluated the relationship between maternal iodine deficiency and the frequency of recall due to high TSH value in newborn screening programs. Methods: 78 mothers who volunteered for the research were included in the study with their newborn babies. Thyroid function tests were examined in the blood serum of newborns with high heel blood TSH value (5.5-20mIU/L) who were referred to the pediatric endocrine with the suspicion of congenital hypothyroidism Urinary iodine levels of healthy mothers without any thyroid disease and iodine exposure were evaluated. Results: The median urinary iodine in mothers was 56.04 μg/l. Only 8 (10.2%) of the recalled newborns had subclinical hypothyroidism and recovered at the follow-up 1 week later, while all the rest had normal thyroid functions. In addition, there was a weak negative correlation between maternal age, the number of children, and urinary iodine levels (respectively, r=0.35,r= 0.33; p=0.001,p=0.003). Conclusion: Only 9%(7 people) of the mothers participating in the study had adequate urinary iodine excretion and almost half (38 people) of the mothers (48.7%) had severe urinary iodine deficiency. Low maternal iodine values are effective in the prolonging transient TSH elevation in newborns, and iodine supplementation to mothers during pregnancy may reduce recall rates of newborn TSH screening. [ABSTRACT FROM AUTHOR]

Introduction: Hypothyroidism is most common endocrine disorder resulting in decreased levels of thyroid hormones. Hypothyroidism can be divided into primary, central and congenital hypothyroidism. Iodine deficiency is the most common cause of primary hypothyroidism. In areas with sufficient dietary iodine, most common cause is hashimoto's thyroiditis. Materials and Methods: Patients attending the OPD and those admitted in wards of Department of General Medicine at a tertiary centre, Bangalore who are newly diagnosed with non diabetic hypothyroidism are selected for the study as cases. The healthy individuals who are age and sex matched to cases are taken as controls. Study is carried out for the period of 18 months from November 2015 to April 2017. Results: A total number of 200 subjects were studied which included: * 100 Controls * 100 patients with newly diagnosed non diabetic hypothyroidism. Discussion: Hypothyroidism is defined as decreased levels of thyroid hormones in blood due to underactive thyroid. The thyroid gland produces hormones that regulate the body's metabolic rate as well as heart and digestive function, muscle control, brain development and bone maintenance. Conclusion: From this study it can be concluded that newly diagnosed non diabetic hypothyroid patients show elevated glycated hemoglobin levels in spite of normal fasting blood sugar levels. [ABSTRACT FROM AUTHOR]

COVID-19 vaccines are an effective public health intervention to reduce COVID-19-related morbidity and mortality. Given that pregnant and lactating women have a higher risk of severe COVID-19 complications, it is paramount to understand the factors that inform vaccine decision-making among this population. In this study, we sought to identify facilitators and barriers to COVID-19 vaccine acceptance and vaccine promotion in pregnant and lactating women in Bangladesh. We conducted 40 in-depth interviews with 12 pregnant women, 12 lactating women, and 16 health workers from one urban and four rural communities in Bangladesh. We used a grounded theory approach to identify emerging themes. Our results suggest that health workers and religious leaders played key roles in promoting COVID-19 vaccines in this population. Further, we found that the culture of trust in public health authorities and the existing vaccine infrastructure facilitated vaccine promotion. However, changes in vaccine eligibility and myths and rumors acted as both facilitators and barriers to vaccine promotion within our study. It is crucial that maternal immunization vaccine promotion efforts push pregnant and lactating women toward vaccine acceptance to protect the health of mothers and their babies. Additionally, as new maternal vaccines are developed and licensed, understanding how to best promote vaccines within this group is paramount. [ABSTRACT FROM AUTHOR]

This article presents cases of congenital goiter in newborn Boer kids, that have been diagnosed recently. Their mothers were related, sisters actually. Of the six kids, two were stillborn, and four have died within 21 hours. We have presented clinical and necropsy results of investigations. Pathomorphological changes suggested a goiter. As a treatment, the females a salt product that is iodized, for licking, to prevent kids goiter development in the next gestation(s). [ABSTRACT FROM AUTHOR]

Objective: The use of parenteral nutrition (PN) formulations that do not contain iodine can contribute to the deficiency of this mineral, potentially leading to hypothyroidism and, ultimately, neurocognitive impairments. This study aimed to evaluate TSH alterations in newborns receiving PN. Methods: Retrospective study of neonatal intensive care unit patients receiving PN for > 15 days. Nutritional, anthropometric, and biochemical variables (TSH, T4, CRP) were analyzed. Hypothyroidism was defined by TSH > 10 mU/L. Results: Two hundred newborns were evaluated [156 (78%) preterm, 31±5 weeks of gestational age, 112 (56%) with very or extremely low birth weight]. The median (IQR) hospital stay was 68 (42-110) days, PN duration was 31 (21-47) days, and 188 (94%) patients also received enteral nutrition. Overall, 143 (71.5%) newborns underwent at least one TSH measurement. The prevalence of hypothyroidism was 10.5%. The Median PN duration in this group was 51 (34-109) days. Among those with hypothyroidism, 10 received Lugol's solution and six levothyroxine. Thirteen patients received prophylactic Lugol's solution with a median PN duration of 63 (48-197) days. TSH levels correlated positively with PN duration (r = 0.19, p = .02). Conclusions: The present data suggest that changes in TSH and T4 levels are present in neonates receiving PN for > 15 days, suggesting this population may be at risk for developing hypothyroidism. Therefore, the authors suggest that TSH and T4 measurements should be included as routine in neonatal patients receiving PN for > 15 days if PN formulations are not supplemented with iodine, and that iodine supplementation be provided as necessary.

Epidemiological studies of late effects of preconceptional (prior to conception) radiation exposure are necessary in order to understand the risks of tumor and non-tumor pathology in next generations. Research of possible relation between parental preconceptional exposure and development of endocrine and metabolic disorders in the offspring is one of the topical issues of radiation hygiene. The objective of the study: comparative analysis of endocrine and metabolic pathology in children of the individuals exposed to long term preconceptional external gamma-radiation at the Mayak Production Association – at the first atomic industry facility on Russia. Materials and methods: A retrospective research was performed based on the Ozyorsk Children’s Health Registry. Ozyorsk – the city where Mayak Production Association is the enterprise forming the city. Analysis of endocrine and metabolic disorders was performed for 13880 children of 1949-1973 years of birth who were born and resided in Ozyorsk; parents of 9321 children of this number had accumulated doses of prolonged external gamma-radiation exposure at the production facility prior to conception. A comparative analysis of the structure and incidence of “Endocrine, nutritional and metabolic diseases” and nosological forms of this class of pathology was performed. Characteristic features of parental preconceptional exposure were analyzed in relation to thyroid pathology in children. Relative risk of endocrine and metabolic disorders among the children of exposed and unexposed parents was calculated for the whole disease class and for certain nosologies. Results: A significant predominance of thyroid diseases, particularly, iodine deficiencies, was detected at an earlier age among the offspring of Mayak Production Association workers compared to the control group; these cases were mostly related to low dose parental preconceptional exposure. Thyroid cancer was further detected in 0.16% (15/9321) of the studied cohort of the offspring of exposed parents with average manifestation age of 42.6. Relative risk of thyroid diseases was significantly higher among the exposed parents’ offspring compared to the controls: 2.0 among boys (95% confidence interval 1.38-2.9), 1.59 among girls (1.25-2.02) and in the group as a whole – 1.64 (1.34- 2.01). Relative risk of thyroid diseases related to iodine deficiency among the offspring of Mayak Production Association personnel was almost twice higher than the in the control group: 1.92 (1.3-2.84) among boys, 1.68 (1.29-2.2) among girls, 1.7 (1.36-2.12) in the whole group. Discussion and conclusion: A statistically significant overweight of non-tumor thyroid pathology in the offspring of Mayak Production Association personnel cannot be explained through external reasons taking into account similar climate and geographic conditions, possible technogenic exposure and the same unified medical survey of the followed children. We cannot exclude increased sensibility if thyroid tissue to iodine deficiency and its predisposition to hypertrophy and hyperplasia among the offspring of individuals exposed to long term occupational contact with ionizing radiation sources; that should be taken into account in the course of medical monitoring of these patients. Further research of transgenerational effects in the offspring of personnel of radiation hazardous production facilities are needed for complete understanding of the role of parental occupational exposure in health risks for further generations.

Background: The recommended urinary iodine concentration (UIC) levels in the overall adult population is 100–199 μg/L whereas 150–249 μg/L in pregnant women. Objectives: The objective is to determine the prevalence and severity of iodine deficiency in pregnant women in Amasya, which is located in the Western Black Sea region in Turkey, where sufficient iodine levels were achieved in the normal population. Methods: In this single-center study, we retrospectively searched hospital patient records and identified pregnant women who were assessed for iodine levels between January 2019 and January 2021. A total of 408 pregnant women were found eligible for the study. Thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroid peroxidase antibodies, and antithyroglobulin antibodies in serum samples and UIC were evaluated and compared between the trimesters. Insufficient iodine intake in pregnancy was defined as UIC 2.5 mIU/L in the 1st trimester. Conclusion: Iodine deficiency in pregnancy may exist in an iodine-sufficient population. Appropriate measures must be taken to ensure sufficient iodine levels in these individuals.

Introduction: Iodine deficiency can cause several diseases in children and adults. Therefore, it is important to monitor iodine supplementation. The present study aimed to evaluate the Iodine levels in table salts consumed in Algeria. Materials and method: A total of 81 salt samples were purchased from different retailers. Iodine levels were determined using Inductively Coupled Plasma Mass Spectrometry after digestion procedure. Statistical analysis and data visualization were performed using Rstudio 4.2.2 software. Results and discussion: In total, 11 products mentioned the iodine content in their packaging, 05 products mentioned an iodine level which did not in accordance with the Algerian regulations (50.55–84.25 mg/kg). In addition, iodine content varied in the samples of the same brand, indicating a poor reproducibility in the process of iodination. Additionally, 26 samples were free of iodine and only 03 products respected the recommendation of the World Health Organization regarding iodine content in table salts (20–40 mg/kg). Conclusion: The analysed table salt samples were not compliant to national and/or international regulations, exposing to an iodine deficiency that could impacts negatively consumers’ health. Thus, it is essential to strengthen the quality control of dietary salts and to set up a nutrivigilance system.

Objective: To assess the iodine status and its associations with thyroid function in pregnant women of Shanghai. Methods: In this cross-sectional study, a total of 562 pregnant women were enrolled from January to December 2021. Both serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidase antibody (TPOAB), thyroglobulin antibody (TGAB), and urinary iodine concentration (UIC) were detected. Participants were divided into four groups based on their UIC values. Correlation analysis was used to investigate the association between UIC and thyroid function-associated parameters. Results: The median UIC of the pregnant women studied was 158.25µg/L (interquartile range [IQR] 90.15, 245.65µg/L). Among all the subjects, 45.55% had iodine deficiency according to the World Health Organization (WHO) criteria, and 15.65% had thyroid autoimmunity. FT3, FT4, TSH, TPOAB and TGAB levels were not different among different UIC groups (P > 0.05). UIC and TSH were negatively correlated (r=-0.127, p=0.043) in UIC<150 µg/L group. In the group with UIC 250-499 µg/L, UIC was positively correlated with total T4 (TT4), total T3 (TT3) and TPOAB (r= 0.228, p=0.022, r=0.208, p= 0.039, r=0.190, p=0.042, respectively). A negative correlation between UIC and TPOAB values was observed in TPOAB-positive (+) pregnant women (r=-0.384, p=0.012). The prevalence of isolated hypothyroxinemia in UIC<150 µg/L group was significantly higher than that of other groups(p=0.033). The relationship between the prevalence of thyroid diseases and UIC embodied a U-shaped curve. Conclusion: Pregnant women on Chongming Island of Shanghai were iodine sufficient during the second trimester, but iodine deficiency was still prevalent. Both low and high gestational iodine status was related to thyroid function and autoimmunity. Optimal iodine nutrition status during gestation was important. [ABSTRACT FROM AUTHOR]

Background: Improving the potency of immune response is paramount among issues concerning immunotherapy of muscle‐invasive bladder cancer (MIBC). Methods: On the basis of immune subtypes, we investigated possible molecular mechanisms involved in tumor immune escape in MIBC. According to the 312 immune‐related genes, three MIBC immune subtypes were clustered. Results: Cluster 2 subtype is characterized by FGFR3 mutations and has a better clinical prognosis. However, the expression levels of MHC‐I and immune checkpoints genes were the lowest, indicating that this subtype is subject to immune escape and has a low response rate to immunotherapy. Bioinformatics analysis and immunofluorescence staining of clinical samples revealed that the FGFR3 is involved in the immune escape in MIBC. Besides, after FGFR3 knockout with siRNA in RT112 and UMUC14 cells, the TLR3/NF‐kB pathway was significantly activated and was accompanied by upregulation of MHC‐I and PD‐L1 gene expression. Furthermore, the use of TLR3 agonists poly(I:C) can further improve the effect. Conclusion: Together, our results suggest that FGFR3 might involve in immunosuppression by inhibition of NF‐kB pathway in BC. Considering that TLR3 agonists are currently approved for clinical treatment as immunoadjuvants, our study might provide more insights for improving the efficacy of immunotherapy in MIBC. [ABSTRACT FROM AUTHOR]

Background: Iodine deficiency is a global public health threat, affecting an estimated two billion people. The median urinary iodine concentration is more reliable in determining recent iodine intakes and the risks of iodine deficiency. Therefore, this study was aimed to identify the factors associated with recent iodine intake level using median urinary iodine concentration as an indicator among household food handlers in southwest Ethiopia. Methods: A community-based survey was conducted with selected households using a pretested interviewer-administered questionnaire in southwest Ethiopia. A 20-gram sample of table salt and a 5 ml causal urine samples were also collected and analyzed using rapid test kit and a Sandell-Kolthoff reaction, respectively. A salt iodine concentration above 15 ppm was classified as adequately iodized and a median urinary iodine concentration between 100 and 200µgl− 1 was considered as adequate iodine intake. A bivariable and multivariable logistic regression model was fitted. Crude and adjusted odds ratios with their 95% confidence levels were reported. Associations with a p-value ≤ 0.05 were used to declare statistical significance. Results: A total of 478 women were included, with a mean age of 33.2 (± 8.4 years). Only 268 (56.1%) of the households had adequately iodized salt (> 15 ppm). The median urinary iodine concentration (interquartile range) was 87.5 µg l− 1 (45.6-107.6). In a fitted multivariable logistic regression model (p-value = 0.911), illiterate women (AOR = 4.61; 95% CI: 2.17, 9.81), poorly iodized salt in the household (AOR = 25.0; 95% CI: 13–48), salt purchased from open market (AOR = 1.93; 95% CI: 1.0, 3.73) and women who do not read the label during purchasing the salt (AOR = 3.07; 95% CI: 1.31, 7.17) were important predictors of the risk of Iodine deficiency. Conclusion: Despite public health efforts to improve iodine intake, its deficiency is still a major public health problem among southwest Ethiopian women. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid dysfunction is a common endocrine disorder, defined as the altered serum Thyroid Stimulating Hormone (TSH) levels with normal or altered FT3 and FT4 (triiodothyronine and thyroxine) levels. The spectrum of thyroid disorders includes hypothyroidism, hyperthyroidism, goiter/iodine deficiency disorders, autoimmune thyroiditis, thyroid cancer, as well as subclinical hypothyroidism or hyperthyroidism. However, further research is required on the spectrum of thyroid disorders, apart from goiter/iodine deficiency disorders in the study population mentioned. Aim: To investigate the prevalence and patterns of thyroid disorders in the clinical biochemistry laboratory of a tertiary care hospital in the hilly region of Uttarakhand, India. Materials and Methods: Present cross-sectional study was conducted in the clinical biochemistry laboratory of Veer Chandra Singh Garhwali (VCSG) Govt. Institute of Medical Science and Research Centre, Srinagar Garhwal, Uttarakhand, India. The study population consisted of 950 subjects who underwent Thyroid Function Test (TFT) panel investigation from January 1, 2018 to December 31, 2020. The collected data were analysed using descriptive statistical tools (mean, frequency, percentage) and correlation analysis of thyroid disorder with age and gender using Spearman's rank correlation test. Results: Among 950 TFT panel reports, thyroid dysfunction was prevalent in 386 (40.63%) patients, of which 307 (79.53%) were females and 79 (20.47%) were males. The mean age±SD of the 386 patients with thyroid dysfunction was 32.24±8.77 years. Among these 386 thyroid dysfunction patients, the majority, 264 (68.39%) were in the 19-39 years age group. A very weak statistical correlation was observed between thyroid dysfunction with age and with gender among the 386 patients. Out of the total number of patients (950), 156 patients had euthyroid hyperthyroxinaemia (16.42%), 101 had subclinical hypothyroidism (10.63%), 74 had euthyroid sick syndrome (7.78%), 42 had subclinical hyperthyroidism (4.42%), 10 had primary (overt) hypothyroidism (1.05%), one had primary (overt) hyperthyroidism (0.11%), and two had secondary hyperthyroidism (0.21%). Conclusion: The prevalence of thyroid dysfunction in the present study was high, with a greater proportion in females and the 19-39 years age group. The most common disorders observed were euthyroid hyperthyroxinaemia, subclinical hypothyroidism, and euthyroid sick syndrome. [ABSTRACT FROM AUTHOR]

Background: We aimed to assess the long-term effects of the transition in iodine status on the incidence of thyroid disorders over 20 years of follow-up. Methods: The original prospective cohort study, started in 1999 (n = 3761), classified three regions in north China based on iodine status (insufficient iodine, more than adequate iodine, and excessive iodine, respectively) for 5 years. Subsequently, participants were followed for up to another 15 years to assess the long-term effects of shifts to adequate iodine on the incidence of thyroid disorders. Panshan transitioned from insufficient to adequate iodine, and Huanghua transitioned from excessive to more than adequate iodine. Both regions were compared with Zhangwu, in which iodine status changed from more than adequate to adequate iodine (from 214 to 167.2 μg/L). A cluster sampling method was used to select participants in the three regions. Participants completed questionnaires and underwent thyroid ultrasonography. Urinary iodine concentrations (UICs), serum thyroid hormone concentration, and thyroid antibodies were measured. Results: When the iodine status changed from insufficient to adequate (with the median UIC increasing from 88 to 141.9 μg/L), the incidence density of subclinical hyperthyroidism, positive thyroperoxidase antibody, positive thyroglobulin antibody (TgAb), and goiter decreased significantly (p < 0.05 for all). Additionally, the cumulative incidence of subclinical hypothyroidism was significantly lower compared with the region where the iodine status changed from being more than adequate to adequate (1.9% vs. 6.0%, p < 0.001). When the iodine status changed from excessive to more than adequate (median UIC from 634 to 266.7 μg/L), a significant decrease in the incidence density of subclinical hyperthyroidism, positive thyroid antibodies, positive TgAb, and goiter (p < 0.05 for all) were also found. However, an increase in thyroid nodule incidence density (17.26 vs. 28.25 per 1000 person-years, p < 0.001) was seen. Conclusions: The incidence of thyroid disorders (except for thyroid nodules) stabilized or decreased among adults in the three communities from year 5 to year 15 of follow-up. Appropriate iodine fortification is safe and effective over the long term. Restoring urinary iodine to appropriate levels reduces population risk for thyroid disorders. [ABSTRACT FROM AUTHOR]

Histamine is involved in the regulation of immune response, vasodilation, neurotransmission, and gastric acid secretion. Although elevated histamine levels and increased expression of histamine metabolizing enzymes have been reported in renal disease, there is a gap in knowledge regarding the mechanisms of histamine-related pathways in the kidney. We report here that all four histamine receptors as well as enzymes responsible for the metabolism of histamine are expressed in human and rat kidney tissues. In this study, we hypothesized that the histaminergic system plays a role in salt-induced kidney damage in the Dahl salt-sensitive (DSS) rat, a model characterized with inflammation-driven renal lesions. To induce renal damage related to salt sensitivity, DSS rats were challenged with 21 days of a high-salt diet (4% NaCl); normal-salt diet (0.4% NaCl)-fed rats were used as a control. We observed lower histamine decarboxylase and higher histamine N-methyltransferase levels in high-salt diet-fed rats, indicative of a shift in histaminergic tone; metabolomics showed higher histamine and histidine levels in the kidneys of high-salt diet-fed rats, whereas plasma levels for both compounds were lower. Acute systemic inhibition of histamine receptor 2 in the DSS rat revealed that it lowered vasopressin receptor 2 in the kidney. In summary, we established here the existence of the local histaminergic system, revealed a shift in the renal histamine balance during salt-induced kidney damage, and provided evidence that blockage of histamine receptor 2 in the DSS rat affects water balance and urine concentrating mechanisms. [ABSTRACT FROM AUTHOR]

The relevance of the problem under study lies in the need to develop innovative approaches to the introduction of fruit crops into the diet to avoid the loss of nutrients and thus help prevent micronutrient deficiency in the human body. In this regard, the purpose of this article is to study the content of biologically active substances in the products of promising persimmon varieties and their effect on the normal functioning of the thyroid gland. The following results were obtained during the study: soil and climatic conditions affecting the nutritional value of the agricultural product were presented. It was established that Shaki-Zagatala economic region is an iodine deficiency endemic area and belongs to the zone of moderate iodine (I) deficiency. The quantity of macro and microelements in fruits of 20 varieties of Oriental persimmon (Diospyros kaki) bred by folk selection growing in Shaki-Zagatala economic region was studied and compared by regions; the use of persimmon plants in the food industry as a way of increasing the amount of iodine in the human body was substantiated. It has been proved that in order to eliminate iodine deficiency, it is advantageous to eat more food enriched with iodine from fruits of the Oriental persimmon (D. kaki), which is rich in microelements. The role of awareness – raising activities among the population regarding health disorders associated with iodine deficiency was revealed. The practical value of the article materials consists in obtaining detailed information about biochemical composition of Oriental persimmon fruit (D. kaki) for the purpose of iodine deficiency prevention. The technologies of processing and storage of the product in fresh and processed form to preserve the useful properties of persimmon have been proposed in order to increase the profitability of production and increase the level of sales of products in the Shaki-Zagatala economic region of Azerbaijan. [ABSTRACT FROM AUTHOR]

Background: Iodine intake remains an issue for women of childbearing age. While it is essential for women to consume adequate levels of iodine during pregnancy, it is equally important that women of childbearing age consume sufficient amounts of iodine, especially those who are planning pregnancy. Objective: This study assessed the iodine status of women of reproductive age (15-49 years) in Rivers State, Nigeria. Methods: The population for the study comprised all female senior secondary students and teachers between 15-49 years in the three senatorial zones of Rivers State. The minimum sample size required for the study was 320 women estimated using the Cochrane formula. A cross sectional study design was used in which both qualitative and quantitative data collection methods were employed. Results: The median urinary iodine concentration of the study population (129.06 µg/L) indicated that the women had optimal iodine nutrition. The percentage of urinary iodine concentration (UIC) below 50 µg/L in the women indicated that iodine deficiency among childbearing-age women has not yet been eliminated. A greater percentage of the women (44.16%) had more than the adequate iodine nutrition, while 6.49% were excessive. Conclusion: The iodine status of the women showed that none of the women were deficient. However, half of the respondents have high intake (200 µg/L) and are at risk of iodine induced hyperthyroidism. Public awareness regarding the rate of iodine deficiency in women of reproductive age is therefore recommended. [ABSTRACT FROM AUTHOR]

It is unclear how maternal glycemic status and maternal iodine status influence birth weight among individuals with mild-to-moderate iodine deficiency (ID). We studied the association between birth weight and both maternal glucose levels and iodine intake among pregnant women with mild-to-moderate ID. Glucose values were assessed using a glucose challenge test (GCT) and non-fasting glucose levels that were determined before delivery; individuals' iodine statuses were assessed using an iodine food frequency questionnaire; and serum thyroglobulin (Tg) and urinary iodine concentrations (UIC) were used to assess each group's iodine status. Thyroid antibodies and free thyroxine (FT4) levels were measured. Obstetric and anthropometric data were also collected. Large-for-gestational age (LGA) status was predicted using a Cox proportional hazards model with multiple confounders. Tg > 13 g/L was independently associated with LGA (adjusted hazard ratio = 3.4, 95% CI: 1.4–10.2, p = 0.001). Estimated iodine intake correlated with FT4 among participants who reported consuming iodine-containing supplements (ICS) after adjusting for confounders (β = 0.4, 95% CI: 0.0002–0.0008, p = 0.001). Newborn weight percentiles were inversely correlated with maternal FT4 values (β = −0.2 95% CI:−0.08–−56.49, p = 0.049). We conclude that in mild-to-moderate ID regions, insufficient maternal iodine status may increase LGA risk. Iodine status and ICS intake may modify the effect that maternal dysglycemia has on offspring weight. [ABSTRACT FROM AUTHOR]

Introduction: Iodine is a pivotal component of thyroid hormones, and its deficiency leads to negative pregnancy outcomes. Therefore, during gestation, additional iodine supplementation is recommended. Objectives: By evaluating a group of women from western Poland, the study updated on iodine status during pregnancy and the effectiveness of iodine supplementation in relation to the maternal and neonatal thyroid function. Patients and methods: A total of 91 women were recruited before the delivery between 2019 and 2021. During the medical interview, the patients declared their dietary supplements intake. Thyroid parameters (TSH, ft3, ft4, a-TPO, a-Tg, and TRAb) were measured in the serum of mothers and in the cord blood of newborns after birth. Urinary iodine concentration (UIC) and urine/creatinine (UIC/crea) ratio were assessed in single urine samples using a validated high-performance liquid chromatography with ultraviolet detection (HPLC-UV). Neonatal TSH screening from dried blood spot was analyzed. Results: Pregnant women showed a median (interquartile range) UIC of 106 (69-156) µg/liter and UIC/crea ratio of 104 (62-221) µg/g, whereas approximately 20% had UIC/crea below 50 µg/g, indicating iodine deficiency. The iodine supplementation ratio was 68%. No significant differences in UIC, UIC/crea and thyroid parameters were found between iodine supplemented and non-supplemented groups; however, the highest ioduria was detected when iodine was supplemented in addition to levothyroxine in comparison with both substances administered separately. Patients with UIC/crea within 150-249 µg/g demonstrated the lowest TSH and a-TPO levels. Screening TSH was above 5 mIU/liter in 6% of children. Conclusions: Despite the national salt iodization and the recommendation to supplement iodine during gestation, the status of the abovementioned microelement and real-life intake revealed the ineffectiveness of the current iodine-deficiency prophylaxis model in pregnancy. [ABSTRACT FROM AUTHOR]

Background: The common reference intervals (RIs) for thyroid hormones currently used in China are provided by equipment manufacturers. This study aimed to establish thyroid hormone RIs in the population of Lanzhou, a city in the subplateau region of northwest China, and compare them with previous reports and manufacturer-provided values. Methods: In total, 3,123 individuals (1,680 men, 1,443 women) from Lanzhou, an iodine-adequate area of China, perceived as healthy were selected. The Abbott Architect analyzer was used to determine the serum concentration of thyroid hormones. The 95% RI was estimated using the 2.5th and 97.5th percentiles as the lower and upper reference limits, respectively. Results: The serum levels of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), antithyroglobulin (ATG) antibody, and antithyroid peroxidase (ATPO) antibody levels were significantly correlated with sex (P<0.05). TSH, total thyroxine (TT4), and ATPO levels were significantly correlated with age (P<0.05). The serum levels of TSH, ATG, and ATPO in men were significantly lower than in women; in contrast, the serum TT3 level was significantly higher in men than in women (P<0.05). Serum TSH, TT3, TT4, and ATG levels differed across age groups (P<0.05), but no such variation was observed for ATG levels (P>0.05). The established RIs of TSH, ATG, and ATPO in this study differed between sexes (P<0.05). The thyroid hormone RIs established herein were inconsistent with the manufacturer-provided values. Conclusion: The RIs of thyroid hormones in the healthy population of Lanzhou were inconsistent with those in the manufacturer's manual. Validated sex-specific values are required for diagnosing thyroid diseases. [ABSTRACT FROM AUTHOR]

Background: Iodine is required for the synthesis of thyroid hormone (TH), but its natural availability is limited. Dehalogenase1 (Dehal1) recycles iodine from mono- and diiodotyrosines (MIT, DIT) to sustain TH synthesis when iodine supplies are scarce, but its role in the dynamics of storage and conservation of iodine is unknown. Methods:Dehal1-knockout (Dehal1KO) mice were generated by gene trapping. The timing of expression and distribution was investigated by X-Gal staining and immunofluorescence using recombinant Dehal1-beta-galactosidase protein produced in fetuses and adult mice. Adult Dehal1KO and wild-type (Wt) animals were fed normal and iodine-deficient diets for 1 month, and plasma, urine, and tissues were isolated for analyses. TH status was monitored, including thyroxine, triiodothyronine, MIT, DIT, and urinary iodine concentration (UIC) using a novel liquid chromatography with tandem mass spectrometry method and the Sandell–Kolthoff (S-K) technique throughout the experimental period. Results: Dehal1 is highly expressed in the thyroid and is also present in the kidneys, liver, and, unexpectedly, the choroid plexus. In vivo transcription of Dehal1 was induced by iodine deficiency only in the thyroid tissue. Under normal iodine intake, Dehal1KO mice were euthyroid, but they showed negative iodine balance due to a continuous loss of iodotyrosines in the urine. Counterintuitively, the UIC of Dehal1KO mice is twofold higher than that of Wt mice, indicating that S-K measures both inorganic and organic iodine. Under iodine restriction, Dehal1KO mice rapidly develop profound hypothyroidism, while Wt mice remain euthyroid, suggesting reduced retention of iodine in the thyroids of Dehal1KO mice. Urinary and plasma iodotyrosines were continually elevated throughout the life cycles of Dehal1KO mice, including the neonatal period, when pups were still euthyroid. Conclusions: Plasma and urine iodotyrosine elevation occurs in Dehal1-deficient mice throughout life. Therefore, measurement of iodotyrosines predicts an eventual iodine shortage and development of hypothyroidism in the preclinical phase. The prompt establishment of hypothyroidism upon the start of iodine restriction suggests that Dehal1KO mice have low iodine reserves in their thyroid glands, pointing to defective capacity for iodine storage. [ABSTRACT FROM AUTHOR]

Objective: Gestational transient thyrotoxicosis (GTT) and Graves' disease (GD) are the most common causes of hyperthyroidism during pregnancy. However, few studies have compared pregnancy outcomes of patients who had GTT with those who had GD in the first trimester of pregnancy. Methods: We conducted a prospective multicenter cohort study in China. Participants received questionnaires, physical examinations, and underwent measurements of thyrotropin (TSH), free thyroxine (fT4), thyroid peroxidase antibody (TPOAb), TSH receptor antibody (TRAb), and urinary iodine in the first trimester. The patients diagnosed with either GTT or GD and normal thyroid function (NTF) group were followed until delivery. The thyroid function and pregnancy outcomes were reported. Results: A total of 125 pregnant women with thyrotoxicosis and 246 age-matched pregnant women with NTF were included. (1) The thyroid function of the GTT group returned to normal range in the third trimester, but was consistently abnormal in the GD group. (2) The incidence of gestational diabetes mellitus (GDM) in the GTT group (11.5%, 9/78) was significantly higher than that in NTF group (4.9%, 12/246) (p = 0.037). The incidence of premature delivery in the GD untreated (30.8%, 8/26, p = 0.002) and treated groups (28.6%, 6/21, p = 0.008) was both, respectively, higher than that in the NTF group (7.7%, 19/246). Miscarriage (15.4%, 4/26 vs. 3.7%, 9/246, p = 0.026) and gestational hypertension (19.2%, 5/26 vs. 3.3%, 8/246, p = 0.004) were more prevalent in the GD untreated group than in the NTF group. (3) The presence of positive TRAb and positive TPOAb in the first trimester were independent risk factors for miscarriage (odds ratio [OR] = 5.23, confidence interval [CI] = 1.11–24.78, p = 0.037) and low birth weight infants (OR = 7.76, CI = 1.23–48.86, p = 0.029), respectively. Conclusion: In conclusion, pregnancy outcomes appear variable, according to the etiology of first trimester thyrotoxicosis. GTT appears to be associated with GDM. GD appears to be associated with an increased risk of premature delivery, gestational hypertension, and miscarriage. The diagnosis of GTT and GD patients during early pregnancy and appropriate treatment of GD patients may be associated with improved pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Objective: To compare Lugol's Iodine and Methylene blue as an adjunctive tool for early diagnosis of premalignant oral lesions by taking histopathology as the gold standard. Study Design: Cross-sectional descriptive. Setting: Outpatient Department of Isra Dental College Hospital, Isra University Hyderabad. Period: January 2021 to July 2021. Material & Methods: All patients with oral premalignant lesions were selected. Methylene blue and iodine staining were used in the lesion area. The dye was applied directly with a cotton bud for 10-20 seconds, and the mouth was rinsed with tap water. The dye retention pattern was evaluated by the stain retention intensity on the lesion. Incisional biopsy was performed simultaneously at that site as a gold standard. Results: Out of 60 cases, males were 49 (81.6%) and females were 11(18.3%). The mean age of males and females was 41.910.7 years and 39.87.74 years, respectively. Out of all patients, 65.0% had more than one addictive habit of mainpuri, gutka, or supari. The commonest region of oral lesions was the buccal mucosa among 61.6% of patients, followed by the alveolus in 16.6%, lips 8.3%, tongue 6.6%, and retro molar area 3.33%, while the palate and floor of the mouth were involved in 1.66% of patients. According to the diagnostic accuracy of methylene blue, the sensitivity was 89.4% and the specificity was 66.6%. According to the Lugol's, iodine sensitivity was 83.3% and specificity was 50%. Conclusion: It has been determined that methylene blue and lugols iodine staining are the best, easy, and noninvasive screening tools to detect the early diagnosis of malignancy. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the iodine status in this study in pregnant women, diabetic women-men, and nondiabetic men-women living in our region. Methods: A total of 385 cases who applied to the endocrine clinic between 2015 and 2020 were reviewed retrospectively. The gender, age, free T3 (pg/ml), free T4 (ng/dl), TSH (µIU/mL), anti-TPO antibody (IU/ml), anti-thyroglobulin antibody (IU/ml), and random urine iodine concentration (µg/L) levels of cases were recorded. The cases were grouped as pregnant, female, male, diabetic female, and diabetic male. Cases with overt thyroid disease, heart failure, liver failure, and kidney failure were excluded. Results: There were 6.75% (n = 26) pregnant, 54.8% (n = 211) nondiabetic female patients, 18.9% (n = 73) diabetic female patients, 12.7% (n = 49) nondiabetic male, and 4.15% (n = 16) diabetic male patients. The random urinary iodine level was significantly higher in nondiabetic women (112.9 ± 77.21) and diabetic women (140.7 ± 97.8) than in pregnant women (77.8 ± 31.8) (P = 0.00 and P = 0.03). There was no significant relationship between random urine levels of pregnant women and nondiabetic men (104.1 ± 82.6) (P = 0.16). The random urinary iodine level was significantly higher in diabetic men (170.0 ± 112.1) than in pregnant women (P = 0.00). Conclusions: In our region (xxx Region), pregnant women had iodine deficiency. The iodine level in men and women was very close to the lower limit. The urinary iodine level was higher in diabetic women and diabetic men than in both pregnant women and nondiabetic women and nondiabetic men. The results brought us the question: Could the high spot urinary iodine level in diabetic patients be a clue to nephropathy? [ABSTRACT FROM AUTHOR]

Body height and body mass index (BMI) are associated with later life outcomes in present and historical populations. We examine the case study of the Swiss Alpine canton of Glarus, which was highly industrialised at the beginning of the 20th century. Our study links conscription registers to genealogical registers at the individual level in Switzerland for the first time. We analyse whether body height, BMI, socioeconomic position (HISCLASS), region of residence, fitness to serve (as a proxy for health status in a military context), and goitre status (as a proxy for iodine deficiency) in young adulthood are associated with lifespan. We transcribed conscription records of 1073 men born between 1905 and 1907 and recruited between 1925 and 1927 (coverage birth cohorts 96%). Of the 827 young men residing within the canton, we were able to identify 635 (76.8%) in the cantonal genealogical register. Using body height, chest circumference, and upper arm circumference, we estimated BMI. We find socioeconomic differences for height and estimated BMI at conscription age. Young men with a recorded goitre were taller. We also present a positive association between body height and lifespan, with small men being particularly disadvantaged. In a small subsample of two municipalities, we estimated the heritability of height to be 65%. [ABSTRACT FROM AUTHOR]

Epsom salt as Osteoarthritis (OA) pain therapy has been limited to compresses, foot soaks, and baths. Many studies have examined Epsom salt to reduce pain, especially in OA, but Epsom salt formulation in gel form has never been tried, so it needs in-depth scientific evidence. This study aims to formulate an Epsom salt gel and test its effectiveness in reducing pain for OA patients. This is a trueexperimental study with a completely randomized design. A total of 22 respondents with OA were included in the trial. In this study, each respondent received five treatments randomly (administration of pure gel (Negative control); Epsom salt gel with a concentration of 2%; 2.5%; 3%, and Diclofenac sodium (Positive control). Respondents' pain scale was assessed at the beginning and the end of each treatment as an outcome in this study. The data were analyzed using One-Way ANOVA and Tukey HSD. Epsom salt gels were successfully made with 2%, 2.5%, and 3% concentrations. The formulation results have met the physical test of gel preparation (organoleptic test, homogeneity, pH, and consistency). The results of clinical trials found that all Epsom salt gel concentrations effectively reduce OA pain levels (p<0.0001 vs. Control negative). Epsom salt gel with a concentration of 3% has a higher effectiveness level than other concentrations (p<0.0001). The effectiveness of Epsom salt gel with a concentration of 3% is almost equivalent to the oral drug diclofenac sodium. In conclusion, Epsom salt gel with a concentration of 3% as a topical drug has significantly reduced OA pain levels. [ABSTRACT FROM AUTHOR]

Introduction: The use of iodinated contrast media (ICM) can lead to thyrotoxicosis, especially in patients with risk factors, such as Graves' disease, multinodular goiter, older age, and iodine deficiency. Although hyperthyroidism may have clinically relevant effects, whether high-risk patients should receive prophylactic treatment before they are administered ICM is still debated. Aim of the study: We aimed to demonstrate the safety and efficacy of prophylactic treatment with sodium perchlorate and/or methimazole to prevent ICM-induced hyperthyroidism (ICMIH) in a population of high-risk cardiac patients. We ran a cost analysis to ascertain the most cost-effective prophylactic treatment protocol. We also aimed to identify possible risk factors for the onset of ICMIH. Materials and methods: We performed a longitudinal retrospective study on 61 patients admitted to a tertiary-level cardiology unit for diagnostic and/or therapeutic ICM-procedures. We included patients with available records of thyroid function tests performed before and after ICM were administered, who were at high risk of developing ICMIH. Patients were given one of two different prophylactic treatments (methimazole alone or both methimazole and sodium perchlorate) or no prophylactic treatment. The difference between their thyroid function at the baseline and 11-30 days after the ICM-related procedure was considered the principal endpoint. Results: Twenty-three (38%) of the 61 patients were given a prophylactic treatment. Thyroid function deteriorated after the administration of ICM in 9/61 patients (15%). These cases were associated with higher plasma creatinine levels at admission, higher baseline TSH levels, lower baseline FT4 levels, and no use of prophylactic treatment. The type of prophylaxis provided did not influence any onset of ICMIH. A cost-benefit analysis showed that prophylactic treatment with methimazole alone was less costly per person than the combination protocol. On multivariate analysis, only the use of a prophylactic treatment was independently associated with a reduction in the risk of ICMIH. Patients not given any prophylactic treatment had a nearly five-fold higher relative risk of developing ICMIH. Conclusion: Prophylactic treatment can prevent the onset of ICMIH in high-risk populations administered ICM. Prophylaxis is safe and effective in this setting, especially in cardiopathic patients. Prophylaxis with methimazole alone seems to be the most cost-effective option. [ABSTRACT FROM AUTHOR]

Background: Skull base invasion in nasopharyngeal carcinoma (NPC) was shown to be a poor negative prognostic factor, and dual-energy CT (DECT) has heralded a new approach to detect this condition. The study aims to evaluate the value of DECT for detection of skull base invasion in NPC and compare the diagnostic performance of DECT with those of simulated single-energy CT (SECT) and MRI. Methods: The imaging findings of 50 NPC patients and 31 participants in control group which underwent DECT examinations were assessed in this retrospective study. The skull base invasions were evaluated using 5-point scale by two blind observers. ROC analysis, Mcnemar test, paired t test, weighted K statistics and intraclass correlation coefficient were performed to evaluate the diagnostic performance of simulated SECT, MRI and DECT. Results: Quantitative analysis of DECT parameters showed higher normalized iodine concentration and effective atomic number values in sclerosis and lower values in erosion than those in normal bones (both p < 0.05). Compared with simulated SECT and MRI, the diagnostic sensitivity for DECT was significantly improved from 75% (simulated SECT) and 84.26% (MRI) to 90.74% (DECT) (both p < 0.001), specificity from 93.23% and 93.75% to 95.31 (both p < 0.001), accuracy from 86.67% and 90.33% to 93.67%, and AUC from 0.927 and 0.955 to 0.972 (both p < 0.05), respectively. Conclusions: DECT demonstrates better diagnostic performance than simulated SECT and MRI for detecting skull base invasions in NPC, even those slight bone invasions in early stage, with higher sensitivity, specificity and accuracy. Clinical relevance statement: DECT demonstrates better diagnostic performance than simulated SECT and MRI for detecting skull base invasions in NPC, which could provide detailed information for determining treatment regimens in NPC patients. Key points: DECT appears to be more accurate in the diagnosis of skull base invasion when compared with SECT and MRI. DECT derived normalized iodine concentration (nIC) and effective atomic number (Zeff) values provide detailed quantitative parameters for diagnosing bone invasions. Different energy-dependent absorption behaviors of DECT helps detecting slight bone invasions with high sensitivity. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (DM) is the most common metabolic disorder in the world and an important risk factor for peripheral arterial disease (PAD). CT angiography represents the method of choice for the diagnosis, pre-operative planning, and follow-up of vascular disease. Low-energy dual-energy CT (DECT) virtual mono-energetic imaging (VMI) has been shown to improve image contrast, iodine signal, and may also lead to a reduction in contrast medium dose. In recent years, VMI has been improved with the use of a new algorithm called VMI+, able to obtain the best image contrast with the least possible image noise in low-keV reconstructions. Purpose: To evaluate the impact of VMI+ DECT reconstructions on quantitative and qualitative image quality in the evaluation of the lower extremity runoff. Materials and Methods: We evaluated DECT angiography of lower extremities in patients suffering from diabetes who had undergone clinically indicated DECT examinations between January 2018 and January 2023. Images were reconstructed with standard linear blending (F_0.5) and low VMI+ series were generated from 40 to 100 keV, in an interval of 15 keV. Vascular attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated for objective analysis. Subjective analysis was performed using five-point scales to evaluate image quality, image noise, and diagnostic assessability of vessel contrast. Results: Our final study cohort consisted of 77 patients (41 males). Attenuation values, CNR, and SNR were higher in 40-keV VMI+ reconstructions compared to the remaining VMI+ and standard F_0.5 series (HU: 1180.41 ± 45.09; SNR: 29.91 ± 0.99; CNR: 28.60 ± 1.03 vs. HU 251.32 ± 7.13; SNR: 13.22 ± 0.44; CNR: 10.57 ± 0.39 in standard F_0.5 series) (p < 0.0001). Subjective image rating was significantly higher in 55-keV VMI+ images compared to the other VMI+ and standard F_0.5 series in terms of image quality (mean score: 4.77), image noise (mean score: 4.39), and assessability of vessel contrast (mean value: 4.57) (p < 0.001). Conclusions: DECT 40-keV and 55-keV VMI+ showed the highest objective and subjective parameters of image quality, respectively. These specific energy levels for VMI+ reconstructions could be recommended in clinical practice, providing high-quality images with greater diagnostic suitability for the evaluation of lower extremity runoff, and potentially needing a lower amount of contrast medium, which is particularly advantageous for diabetic patients. [ABSTRACT FROM AUTHOR]

Using two different energy levels, dual-energy computed tomography (DECT) allows for material differentiation, improves image quality and iodine conspicuity, and allows researchers the opportunity to determine iodine contrast and radiation dose reduction. Several commercialized platforms with different acquisition techniques are constantly being improved. Furthermore, DECT clinical applications and advantages are continually being reported in a wide range of diseases. We aimed to review the current applications of and challenges in using DECT in the treatment of liver diseases. The greater contrast provided by low-energy reconstructed images and the capability of iodine quantification have been mostly valuable for lesion detection and characterization, accurate staging, treatment response assessment, and thrombi characterization. Material decomposition techniques allow for the non-invasive quantification of fat/iron deposition and fibrosis. Reduced image quality with larger body sizes, cross-vendor and scanner variability, and long reconstruction time are among the limitations of DECT. Promising techniques for improving image quality with lower radiation dose include the deep learning imaging reconstruction method and novel spectral photon-counting computed tomography. [ABSTRACT FROM AUTHOR]

This scoping review critically discusses the publications of the last 30 years on the impact of mild to moderate iodine deficiency and the additional impact of endocrine disrupters during pregnancy on embryonal/fetal brain development. An asymptomatic mild to moderate iodine deficiency and/or isolated maternal hypothyroxinemia might affect the development of the embryonal/fetal brain. There is sufficient evidence underlining the importance of an adequate iodine supply for all women of childbearing age in order to prevent negative mental and social consequences for their children. An additional threat to the thyroid hormone system is the ubiquitous exposure to endocrine disrupters, which might exacerbate the effects of iodine deficiency in pregnant women on the neurocognitive development of their offspring. Ensuring adequate iodine intake is therefore essential not only for healthy fetal and neonatal development in general, but it might also extenuate the effects of endocrine disruptors. Individual iodine supplementation of women of childbearing age living in areas with mild to moderate iodine deficiency is mandatory as long as worldwide universal salt iodization does not guarantee an adequate iodine supply. There is an urgent need for detailed strategies to identify and reduce exposure to endocrine disrupters according to the "precautional principle". [ABSTRACT FROM AUTHOR]