RESUMO
The endemic goiter, nutritional collective problem due to iodine deficience, constitutes a chronic disease with easy prevention and control, nevertheless still it constitutes a serious problem of public world health, being thought that about 650 million persons have goiter, 43 millions suffer from endemic cretinism and 1570 millions are in risk of suffering this disease for living in areas that present a deficit of iodine. Both patterns, deficit and the excess of iodine can conducted to a thyroid disease. The relation between the ingestion of iodine and the risk of disease corresponds to a U curve, where both, the low one and high ingestion of iodine it is associate to high risk of thyroid disease. To have a program of iodine supplementation, it should imply a constant vigilance of iodine nutrition to see its effect on the goiter prevalence in the population, to control his degree of fulfillment, to avoid a possible excess of ingestion of iodine it might help to correct any precocious alteration. Endemic goiter is not longer a problem in Chile. Salt iodination is in agreement with present legislation, but it is very important to have a continuous surveillance of iodine nutrition in Chile to control if salt fortification is appropiate.
Assuntos
Humanos , Criança , Bócio Endêmico/epidemiologia , Bócio Endêmico/prevenção & controle , Serviços de Saúde Escolar , Iodo/administração & dosagem , Bócio Endêmico/tratamento farmacológico , Chile , Deficiência de Iodo , América Latina , Distribuição por Sexo , Tireoidite Autoimune/epidemiologia , Tireoidite Autoimune/induzido quimicamente , Iodo/urinaRESUMO
Thyroid nodular disease is a common clinical disorder mainly in iodine lacking regions. This study has evaluated the effectiveness of percutaneous ethanol injection (PEI) in the treatment of single, multiple, solid, and cystic thyroid nodules of different sizes with or without glandular dysfunction, in goiter endemic region. Forty-two patients with diagnosis of colloid goiter or colloid nodular hyperplasia in fine-needle aspiration (FNA) were selected for analysis, after having been submitted to at least two PEI. Thyroid nodules were multiple (solid and or cystic) in 52.4% of the patients, single and solid or mixed in 35.7%, and single and cystic in 11.9%. The mean reduction of nodules after ethanol injection was of 58.2% in the single and of 60.8% in the cystic ones. The reduction of the whole thyroid lobe was evaluated in the multiple nodules and it reached 52.4%. The side-effects were registered only as a consequence of the application discomfort. This study points out that the percutaneous ethanol injection reaching volume mean reductions, varying from 49% to 60%, is a safe, effective, and simple method for the treatment of benign thyroid nodules.
Assuntos
Etanol/uso terapêutico , Bócio Endêmico/tratamento farmacológico , Bócio Nodular/tratamento farmacológico , Solventes/uso terapêutico , Nódulo da Glândula Tireoide/tratamento farmacológico , Biópsia por Agulha Fina , Feminino , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Ultrassonografia de IntervençãoRESUMO
A doença nodular tiroidiana é problema clínico comum, principalmente em regiões com carência de iodo. Esse estudo avaliou a eficácia da injeção percutânea de etanol (IPE) no tratamento de nódulos tiroidianos únicos, múltiplos, sólidos, císticos, de diferentes tamanhos com ou sem disfunção glandular, em região endêmica de bócio. Quarenta e dois pacientes com diagnóstico de bócio colóide ou hiperplasia nodular colóide, na punção biópsia aspirativa por agulha fina (PBAAF), foram selecionados para análise após terem sido submetidos a pelo menos duas IPEs. Os nódulos tiroidianos eram múltiplos (sólidos e ou císticos) em 52,4 por cento dos pacientes, únicos e sólidos ou mistos em 35,7 por cento e únicos e císticos em 11,9 por cento. A redução média dos nódulos após injeção de etanol foi de 58,2 por cento para os únicos e 60,8 por cento nos císticos. Nos nódulos múltiplos, avaliou-se a redução de todo o lobo tiroidiano, alcançando 52,4 por cento de redução. Os efeitos colaterais registrados foram decorrentes apenas do desconforto na aplicação. Este estudo indica que a injeção percutânea de etanol (IPE), alcançando reduções médias de volume que variam de 49 a 60 por cento, é método seguro, eficaz e simples para o tratamento de nódulos tiroidianos benignos.
Thyroid nodular disease is a common clinical disorder mainly in iodine lacking regions. This study has evaluated the effectiveness of percutaneous ethanol injection (PEI) in the treatment of single, multiple, solid, and cystic thyroid nodules of different sizes with or without glandular dysfunction, in goiter endemic region. Forty-two patients with diagnosis of colloid goiter or colloid nodular hyperplasia in fine-needle aspiration (FNA) were selected for analysis, after having been submitted to at least two PEI. Thyroid nodules were multiple (solid and or cystic) in 52.4 percent of the patients, single and solid or mixed in 35.7 percent, and single and cystic in 11.9 percent. The mean reduction of nodules after ethanol injection was of 58.2 percent in the single and of 60.8 percent in the cystic ones. The reduction of the whole thyroid lobe was evaluated in the multiple nodules and it reached 52.4 percent. The side-effects were registered only as a consequence of the application discomfort. This study points out that the percutaneous ethanol injection reaching volume mean reductions, varying from 49 percent to 60 percent, is a safe, effective, and simple method for the treatment of benign thyroid nodules.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Etanol/uso terapêutico , Bócio Endêmico/tratamento farmacológico , Bócio Nodular/tratamento farmacológico , Solventes/uso terapêutico , Nódulo da Glândula Tireoide/tratamento farmacológico , Biópsia por Agulha Fina , Injeções Intralesionais , Resultado do Tratamento , Ultrassonografia de IntervençãoRESUMO
BACKGROUND: Twenty years ago, Pirque was a zone with a goiter prevalence of 39%. AIM: To assess the effects of salt iodination on the prevalence of goiter in school-age children of this zone. SUBJECTS AND METHODS: School age children from four public schools in Pirque were examined, following WHO criteria for the diagnosis of goiter. Urinary iodine excretion was also measured. RESULTS: Five hundred ninety one males and 298 females aged 12.1 +/- 2.5 years were examined. Fifty seven children (9.6%) bad goiter. In 53 the goiter was grade I and in 4, grade II. No sex differences were observed. Minimal and median urinary iodine excretion values were 12.6 and 57.6 micrograms/dl respectively. CONCLUSIONS: Goiter prevalence dropped from 39 to 10%. The fact that iodine intake is over minimal recommendations, underscores the effectiveness of salt iodination.
Assuntos
Bócio Endêmico/epidemiologia , Iodo/uso terapêutico , Adolescente , Criança , Chile/epidemiologia , Feminino , Bócio Endêmico/tratamento farmacológico , Humanos , Iodo/urina , Masculino , PrevalênciaRESUMO
A vida e a obra de Francisco Freire-Allemao médico e botânico brasileiro (1797-1874) foram resumidas neste trabalho de pesquisa histórica, com ênfase especial à tese de doutoramento defendida pelo biografado na Faculdade de Medicina de Paris em 1831, sob o título "Dissertation sur le goître". Para melhor compreensao dos temas desenvolvidos na tese, descrevem-se os eventos que levaram à descoberta do iodo por Courtois e os esforços dos químicos para isolar o halogênio de algas e esponjas marinhas. Menciona-se, a seguir, a terapêutica de bócio com preparaçoes iódicas por Coindet. As viagens de cientistas europeus à America do Sul adicionaram novos conhecimentos da relaçao entre falta de iodo e prevalência de bócio. Boussingault em 1831 argumenta que o sal contendo iodo parece proteger a populaçao contra o flagelo do bócio e suas conseqüências. A análise da tese de Freire-Allemao indica que o autor procurou compilar todos os conhecimentos da época sobre o bócio. Acaba concordando com Boussingault que existe relaçao entre o iodo e a presença de bócio, observando que populaçoes de Minas Gerais que consomem sal de minas de sal nao apresentam bócio, enquanto que os habitantes que usam o sal marinho com freqüência, sao portadores de bócio. Na parte final de sua tese, Freire-Allemao advogam introduçao de iodo para toda a populaçao afetada com bócio, como medida de saúde pública, idéia esta bastante arrojada e seguramente pioneira no início do século XIX. Por sua visao e percepçao do grave problema das doenças devidas a carência de iodo é que podemos considerar Freire-Allemao como pioneiro na avaliaçao desta endemia em nosso país.
Assuntos
Humanos , História do Século XIX , Bócio Endêmico/história , Iodo/história , Bócio Endêmico/prevenção & controle , Bócio Endêmico/tratamento farmacológico , Brasil , Iodo/uso terapêuticoAssuntos
Bócio Endêmico/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Chile , Feminino , Bócio Endêmico/tratamento farmacológico , Humanos , Lactente , Iodetos/uso terapêutico , Masculino , Pessoa de Meia-IdadeRESUMO
The biochemical and morphological changes in thyroid glands were studied in 5 patients with endemic goitre in the region before and one year after the administration of iodized oil. Each patient received a tracer dose of 125-I 3-5 weeks before the biopsy and another tracer of 131-I 12 h before surgery. It was observed that: 1. Iodine deficient goitrous glands had more protein per gram of tissue and that this was corrected by iodination. 2. The goitrous glands exhibited a higher relative proportion of particulate iodoprotein that incorporates more labelled iodine in relation to time of labelling. This abnormal situation is reverted to normal by iodination. 3. A significantly higher proportion of T3 + T4 is synthetized by the glands treated with iodized oil. 4. The increased amount of 127-I per gram of tissue is followed by an increased iodination level of thyroglobulin. 5. The ultracentrifugal pattern of proteins observed for iodine deficient glands differed from the iodinated glands, indicating a failure of maturation of thyroglobulin and possibly a greater than normal degree of heterogeneity. 6. The shift in sedimentation pattern was clearly induced by the increased degree of iodination, as shown by the iodized oil injection. 7. The increased cellularity and the higher rate of protein synthesis in the goitrous glands are reverted to normal after the iodized oil injection.