RESUMEN
O hipotireoidismo congênito é um distúrbio endócrino caracterizado pela diminuição dos níveis séricos dos hormônio da glândula tireóide. Este afeta o metabolismo do cálcio, e, portanto, a formação dos ossos e dentes. É comum nestes pacientes anomalias de formação dentária, atraso na erupção dentária, hipodesenvolvimento do côndilo mandibular e macroglossia. Somados, estes fatores podem ainda levar a uma má-oclusão e ao desenvolvimento inadequado das funções orais. Diante do exposto, Avaliou-se através deste estudo as condições clínicas orais e promoveu-se o atendimento odontológico dos pacientes com esta disfunção endócrina vinculados ao serviço de triagem neonatal do Hospital Universitário da Universidade Federal de Sergipe. Trata-se de um projeto de extensão em que foram atendidos 205 pacientes com idade entre 01 mês e 14 anos, no período de fevereiro à novembro de 2016, os quais passaram por uma avaliação clínica e receberam orientações preventivas. A partir do exame clínico, observou-se que 20% dos pacientes apresentavam alguma necessidade de tratamento odontológico, sendo esses, agendados e encaminhados para a realização do procedimento clínico odontológico. Com os dados obtidos foi possível concluir que é essencial dar aos responsáveis e pacientes as informações necessárias para a prevenção de doenças bucais, estando elas correlacionadas ou não com o Hipotireoidismo Congênito. Além disto, a realização de tratamento clínico, preventivo e curativo nesses pacientes, agregou a Odontologia ao plano multiprofissional já existente representado pelo programa de triagem neonatal do HU UFS.(AU)
Congenital hypothyroidism is an endocrine disorder characterized by a decrease in the serum levels of thyroid gland hormones. This affects the metabolism of calcium, and therefore the formation of bones and teeth. It is common on those patients dental formation anomalies, delayed dental eruption, hypo development of the mandibular condyle and macroglossia. In addition, these factors may also lead to malocclusion and inadequate development of oral functions.In view of the above, this study was chosen as oral clinical conditions and it was promoted in the dental care of patients with this endocrine dysfunction linked to the neonatal screening service of the University Hospital of the Federal University of Sergipe. It is an extension project in which 205 patients aged between 1 month and 14 years were attended, in the period of February to November of 2016, who underwent a clinical evaluation and received preventive guidance. From the clinical examination, it was observed that 20% of the patients had a need for dental treatment, and they were scheduled and sent to perform a dental procedure. With the obtained data, it was possible to conclude that it is essential to give the responsible ones and patients the necessary information for the prevention of oral diseases, being they correlated or not with Congenital Hypothyroidism. In addition, performing clinical, preventive and curative treatment in these patients, added the Dentistry to the existing multiprofessional plan represented by the neonatal screening program of the HU UFS.(AU)
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Enfermedades Periodontales/epidemiología , Hipotiroidismo Congénito/epidemiología , Caries Dental/epidemiología , Maloclusión/epidemiología , Higiene Bucal , Enfermedades Periodontales/etiología , Enfermedades Periodontales/prevención & control , Brasil/epidemiología , Educación en Salud Dental , Hipotiroidismo Congénito/complicaciones , Hipotiroidismo Congénito/prevención & control , Caries Dental/etiología , Caries Dental/prevención & control , Maloclusión/etiología , Maloclusión/prevención & controlRESUMEN
El déficit de yodo (IDD) es un problema de la Salud Pública que afecta a millones de personas en todo el mundo y es causante de alteraciones en la neuromaduración que pueden ser evitados si se realiza una yodoprofilaxis adecuada. Objetivo: Realizar un monitoreo de IDD en la localidad de Wanda, provincia de Misiones, por su ubicación geográfica y hábitos alimentarios con posible consumo regional de sal no iodada. Se estudiaron en 502 escolares de 5 a 14 años de vida , se evaluaron: peso, talla , BMI y palpación tiroidea. En 114 de ellos se determinó la yoduria en muestras casuales de orina. Se analizaron los niveles de TSH de la pesquisa neonatal de los 18 meses previos al estudio, realizados por métodos sensibles (IFMA-DELFIA). Se aplicaron los criterios de suficiencia establecidos por la OMS/ ICCDD. Resultados: La prevalencia de bocio en la región fue de 6.2 %. Los niveles de yoduria tuvieron una mediana de 239 ug/l. El valor de TSH neonatal mediano fue 1.25 uU/ml. Sólo el 1.4 % de las muestras estaban por encima de 5 uU/ml . Cuando se aplicaron los criterios de la OMS pudo observarse que la prevalencia de bocio superaba levemente lo esperado para una zona suficiente, pero no así los niveles de ioduria ni la distribución de TSH neonatal. Conclusión: El aporte iodado de la región evaluada es suficiente como lo demuestran la ioduria y los niveles de TSH neonatal. La presencia de bociógenos como la mandioca en la dieta puede explicar el leve aumento en la prevalencia de bocio. La utilización de la pesquisa neonatal de hipotiroidismo congénito en la supervisión de la deficiencia de yodo añade un beneficio al objetivo primario que es la prevención del retraso mental.
O b j e c t i v e : To estimate the adequacy of iodide intake in Wanda Misiones through the conventional parameters of ioduria and goiter prevalence in scholars as well as with the distribution of TSH neonatal levels as performed for the hypothyroidism screening program in newborns. Population and methods: Height , and BMI and weight were assessed in 502 scholars aged 5 to 14 and expressed as SDS. In 419 of them (215 female) thyro i d volume was evaluated and classified according to WHO (9). In 114 children iodide urinary concentration was measured in casual urine samples by Sandell y Kolthof method modified by Pino (17). Neonatal screening program for congenital hypothyroidism is carried out in the region measuring TSH in filter paper samples with IFMA DELFIA. Since 2000 7.102 newborn have been screened. TSH level's distribution of the 18 months prior to this study (n 267) were evaluated. Criteria suggested by WHO to indicate iodide deficiency were applied. Results: Height, weight and BMI were normal for the chronological age according to Argentinean population parameters. Goitre prevalence was 6.2 % (7.3 % in girls and 5.3 % in boys), higher that expected for a iodide sufficient area. Iodide urine median levels were 239 ug/l with a distribution that excluded iodide deficiency. Neonatal screening program detected 5 congenital hypothyroid children out of the 7102 newborn studied. All of them were early and adequately treated. Only 1.4 % of the 267 samples were > 5 µU/ml, excluding iodide deficiency. Conclusion: Iodide intake in Wanda, Misiones, is adequate as shown by the findings of iodide urine concentration and TSH neonatal levels. A higher prevalence of goitre than expected for this situation, could be explained by dietary intake of goitrogen food as mandioca. Congenital hypothyroidism screening program in this region was extremely effective. The possibility of using its results for iodide intake supervision is an additional benefit to the one of early prevention of mental retardation.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Hipotiroidismo Congénito/prevención & control , Deficiencia de Yodo/diagnóstico , Argentina/etnología , Bocio/prevención & control , Discapacidad Intelectual/prevención & control , Yodo/orinaRESUMEN
El bocio endémico es el aumento de volumen de la glándula tiroides debido principalmente a la escasez de yodo en los alimentos. En el mundo hay aproximadamente un mil millones de personas expuestas a déficit de yodo en la dieta. Sesenta millones de las cuales viven en Iberoamérica, entre ellos los pobladores de las zonas precordilleranas y cordilleranas de Chile, incluyendo Santiago, donde una muestra de escolares mostraba, en el año 1982, prevalencias de 18 por ciento de bocio endémico, que se redujeron a menos de 8 por ciento siete años después de iniciado un programa de yodación de sal de mesa. La prevención del bocio y el cretinismo endémicos se basa en el suministro de yodo a la población, preferentemente en el pan, la sal de cocina, la administración de tabletas de yoduro de potasio o sódico y la administracion intramuscular u oral de aceite yodado, siendo lo mas corriente la incorporación de yodato potásico una parte por 10.000 o 20.000 partes de sal
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Bocio Endémico/etiología , Bocio Endémico/prevención & control , Hipotiroidismo Congénito/prevención & control , Deficiencia de YodoRESUMEN
Iodine deficiency as a major determinant of endemic goiter has been recognized for several decades. The evidence is also strong that iodine supplementation is effective in preventing both varieties of endemic cretinism, provided it is given before conception; early fetal and infant death may also be prevented. However, the reason for the variation in prevalence of the different types of cretinism is still a matter of conjecture. Iodine supplementation may improve motor and cognitive performance, but the evidence needs to be evaluated in light of the difficulty in transposing tests of intellectual and motor ability developed in one culture to another very different one.
Asunto(s)
Hipotiroidismo Congénito/prevención & control , Yodo/administración & dosificación , Adolescente , Adulto , Niño , República Democrática del Congo , Ecuador , Femenino , Humanos , Masculino , Nueva Guinea , PerúAsunto(s)
Hipotiroidismo Congénito/prevención & control , Hipotiroidismo Congénito/terapia , Discapacidad Intelectual/prevención & control , Inteligencia/efectos de los fármacos , Aceite Yodado/uso terapéutico , Preescolar , Enfermedades Carenciales/complicaciones , Ecuador , Estudios de Evaluación como Asunto , Femenino , Edad Gestacional , Humanos , Pruebas de Inteligencia , Aceite Yodado/administración & dosificación , Masculino , Embarazo , Complicaciones del Embarazo/tratamiento farmacológicoAsunto(s)
Hipotiroidismo Congénito/prevención & control , Bocio Endémico/prevención & control , Aceite Yodado/uso terapéutico , Factores de Edad , Puntaje de Apgar , Tasa de Natalidad , Estatura , Peso Corporal , Cefalometría , Preescolar , Ensayos Clínicos como Asunto , Estudios de Evaluación como Asunto , Femenino , Edad Gestacional , Humanos , Lactante , Recién Nacido , Inteligencia/efectos de los fármacos , Pruebas de Inteligencia , Aceite Yodado/administración & dosificación , Masculino , Intercambio Materno-Fetal , Destreza Motora , Perú , Placebos , Embarazo , Complicaciones del Embarazo/tratamiento farmacológicoAsunto(s)
Hipotiroidismo Congénito/prevención & control , Enfermedades Fetales/prevención & control , Aceite Yodado/uso terapéutico , Enfermedades Neuromusculares/prevención & control , Encéfalo/crecimiento & desarrollo , Cefalometría , Niño , Desarrollo Infantil/efectos de los fármacos , Preescolar , Ecuador , Estudios de Evaluación como Asunto , Femenino , Estudios de Seguimiento , Edad Gestacional , Humanos , Lactante , Recién Nacido , Inteligencia/efectos de los fármacos , Aceite Yodado/administración & dosificación , Desarrollo del Lenguaje/efectos de los fármacos , Masculino , Intercambio Materno-Fetal , Destreza Motora , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Población RuralAsunto(s)
Enfermedades Carenciales/prevención & control , Yodo/metabolismo , Australia , Pan/análisis , Hipotiroidismo Congénito/epidemiología , Hipotiroidismo Congénito/etiología , Hipotiroidismo Congénito/prevención & control , Femenino , Bocio Endémico/epidemiología , Bocio Endémico/etiología , Bocio Endémico/prevención & control , Humanos , Hipertiroidismo/epidemiología , Hipertiroidismo/etiología , Hipertiroidismo/prevención & control , Yodo/análisis , Yodo/orina , Radioisótopos de Yodo , Aceite Yodado/administración & dosificación , Masculino , Nueva Guinea , Embarazo , Sales (Química)/administración & dosificación , Comprimidos , Pruebas de Función de la Tiroides , VenezuelaRESUMEN
PIP: Endemic goiter is a health problem in many areas of the world; in some areas the disease is so severe that cretinism and other defects are found. In many areas geographic, economic, and other factors prevent the use of iodized salt as a preventive measure. Field studies were begun in 1966 to determine the feasibility and effectiveness of parenteral administration of iodized oil in goiter prevention. Studies were carried out in Ecuador and Peru. In Ecuador 2 villages were chosen in which the prevalence of goiter was about 60%; in Peru 3 villages were chosen where incidence was about 50%. Prevalence of goiter decreased for 20 months during the study but then began to rise again with the maximum reduction seen up to age 18 and minimal reduction after 40 years of age. The control groups in the study experienced only slight decreases in rate of incidence. Cretinism has not yet appeared among the progeny of the population injected with iodized oil but several instances have appeared in control groups. The use of iodized oil as a public health procedure for the prevention of endemic goiter and its associated defects is an acceptable measure in regions where salt iodization cannot be done.^ieng