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PURPOSE: To evaluate the effect of reconstruction and noise removal algorithms on the accuracy and precision of iodine concentration (CI) quantified with subtracted micro-computed tomography (micro-CT). PROCEDURES: Two reconstruction algorithms were evaluated: a filtered backprojection (FBP) algorithm and a simultaneous iterative reconstruction technique (SIRT) algorithm. A 3D bilateral filter (BF) was used for noise removal. A phantom study evaluated and compared the image quality, and the accuracy and precision of CI in four scenarios: filtered FBP, filtered SIRT, non-filtered FBP, and non-filtered SIRT. In vivo experiments were performed in an animal model of chemically-induced mammary cancer. RESULTS: Linear relationships between the measured and nominal CI values were found for all the scenarios in the phantom study (R2 > 0.95). SIRT significantly improved the accuracy and precision of CI compared to FBP, as given by their lower bias (adj. p-value = 0.0308) and repeatability coefficient (adj. p-value < 0.0001). Noise removal enabled a significant decrease in bias in filtered SIRT images only; non-significant differences were found for the repeatability coefficient. The phantom and in vivo studies showed that CI is a reproducible imaging parameter for all the scenarios (Pearson r > 0.99, p-value < 0.001). The contrast-to-noise ratio showed non-significant differences among the evaluated scenarios in the phantom study, while a significant improvement was found in the in vivo study when SIRT and BF algorithms were used. CONCLUSIONS: SIRT and BF algorithms improved the accuracy and precision of CI compared to FBP and non-filtered images, which encourages their use in subtracted micro-CT imaging.

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Iodine intake in Haiti has increased in recent years thanks to the "Bon Sel" social enterprise approach to salt fortification and distribution by the market segment. However, it was uncertain whether this salt reached remote communities. This cross-sectional study aimed to assess the iodine status of school-age children (SAC) and women of reproductive age (WRA) in a remote region of the Central Plateau. A total of 400 children (9-13 years) and 322 women (18-44 years) were recruited through schools and churches, respectively. Urinary iodine (UIC) and urinary creatinine (UCC) concentrations were measured in spot samples, and thyroglobulin (Tg) on dried blood spots. Their iodine intake was estimated, and dietary information collected. The median (IQR) UIC in SAC was 130 µg/L (79-204, n = 399), and in WRA, 115 µg/L (73-173, n = 322). The median (IQR) Tg in SAC was 19.7 µg/L (14.0-27.6, n = 370), and in WRA, 12.2 µg/L (7.9-19.0, n = 183); 10% of SAC had Tg > 40 µg/L. Estimated iodine intake was 77 µg/day and 202 µg/day in SAC and WRA, respectively. Iodized table salt was rarely consumed, though bouillon was used daily; this is hypothesized to be a major contributor to dietary iodine intake. Iodine intake in this remote region seems to have improved considerably since the 2018 national survey, though SAC remain at risk. These results point to the potential effectiveness of using social business principles to deliver humanitarian solutions.

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Iodine deficiency in pregnancy may lead to adverse maternal and fetal outcomes, including impaired child development. Sociodemographic factors and different dietary habits may be related to iodine status in pregnant women. The aim of this study was to evaluate the iodine status and its predictors among pregnant women in a city of Southeastern Brazil. This cross-sectional study was conducted with 266 pregnant women receiving prenatal care in 8 primary health care units. Sociodemographic, obstetric and health, habits of acquisition, storage and consumption of iodized salt, and dietary iodine intake data were collected through a questionnaire. The iodine content was evaluated in urinary iodine concentration (UIC), household salt and seasonings, and drinking water samples. Pregnant women were categorized into three groups according to the UIC, determined by iodine coupled plasma-mass spectrometry (ICP-MS): insufficient (< 150 µg/L), adequate (150-249 µg/L), and more than adequate iodine nutrition (≥ 250 µg/L). The median (p25-p75) UIC was 180.2 µg/L (112.8-262.7). It was found 38% and 27.8% of insufficient and more than adequate iodine nutrition, respectively. Number of gestations, KI content of supplement, alcohol consumption, salt storage, and frequency of using industrialized seasoning were associated to iodine status. Alcohol consumption (OR = 6.59; 95%CI 1.24-34.87), pack the salt in opened container (OR = 0.22; 95%CI 0.08-0.57), and use industrialized seasoning weekly (OR = 3.68; 95% CI 1.12-12.11) were predictors of iodine insufficiency. The pregnant women evaluated have adequate iodine nutrition. Household salt storage and seasoning consumption were risk factors for insufficient iodine status.

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OBJECTIVES: To evaluate urinary iodine concentration (UIC) in civil servants aged 35-74 years of the Brazilian Study of Adults Health (ELSA-Brasil) to analyze its relationship with sociodemographic, clinical risk factors, lifestyle, urinary Na and thyroid status. DESIGN: Cross-sectional study in six Brazilian cities. METHODS: This analysis included 792 participants with information about urinary iodine concentration (UIC). Thyroid status was defined by serum levels of TSH/FT4 and the current use of antithyroid drugs for treatment of overt hyperthyroidism or levothyroxine to treat overt hypothyroidism. The determination of UIC was carried out with an inductively coupled plasma mass spectrometer (ICP-MS) and was expressed as median with Interquartile Range (IQR). RESULTS: In 792 participants, thereof 52% women, mean age was 51.9 (9.0) years. The median UIC was 219 (IQR, 166-291) for all persons studied, thereof 211 (IQR, 157-276) for women and 231 (IQR, 178-304) for men. According to the WHO classification, for all persons studied, 60% had more than adequate iodine-supply (UIC ≥200 µg/L), 37% were adequately supplied (UIC 100-199 µg/L) and <3% had a deficient iodine status (<100 µg/L). In the 35-44-year age strata, which includes women of childbearing age, 23.2% of women presented less than 150 µg/L of UIC. No differences in UIC were detected according to thyroid status. (P = 0.39) The correlation between Ur-Na and UIC showed a Spearman coefficient of 0.52 (P < 0.0001) and it was also found an association of Ur-Na with UIC: Beta of 1.76 (95% Confidence Interval (95% CI): 1.01 to 2.51. The urinary Na concentration showed a synergy with the UIC, that means medians of 57, 72, 107 and 141 mmol Na/L urine (P < 0.001) in the groups with the four UIC classes according to the WHO grading mentioned above. The very low Na content in the persons exhibiting <100 µg/L UIC seems to reflect also a higher urine volume due to the frequent use of diuretics. The strong relationship between the urinary Na concentration and the UIC points to a dependence of the UIC on the individual consumption of iodized salt, which should be more considered in future studies. The strong relationship between the urinary Na concentration and the UIC points to a dependence of the UIC on the individual consumption of iodized salt, which should be more considered in future studies. CONCLUSIONS: Euthyroid persons were dominating by more than four fifths and no significant association was found between UIC and thyroid status. Although most of the persons studied present more than adequate iodine intake it was observed that nearly a quarter of women in childbearing age are iodine deficient.

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BACKGROUND: Salt iodization has been mandatory in Colombia for over half a century. The iodine status of the population has not been recently evaluated using nationally representative data. OBJECTIVE: We estimated the median urinary iodine concentration (mUIC) of Colombian women and children overall and by individual and environmental characteristics. METHODS: Using data from spot urine samples collected in the 2015 Colombian National Nutrition Survey, we estimated mUIC in 24,248 boys and girls aged 1 to <13 y and 9122 women of reproductive age (WRA). Within each group, we compared mUIC by levels of sociodemographic, anthropometric, and geographic factors by using adjusted median differences with 95% CIs from quantile regression models. RESULTS: mUICs were 395 ± 3 µg/L among children and 381 ± 3 µg/L among WRA. Schoolchildren 5 to <13 y old had higher mUIC (407 ± 3 µg/L) than did preschoolers or toddlers. Girls had 21 µg/L (95% CI: -29, -14) lower mUIC than boys after adjustment. In addition, among children, mUIC was positively associated with household wealth and inversely associated with indigenous compared with mestizo ethnicity, living in the southern or Pacific compared with the central regions of Colombia, and altitude. Among WRA, mUIC was positively associated with obesity and inversely with age, indigenous compared with mestizo ethnicity, education, household wealth, living in southern compared with central Colombia, altitude, and alcohol intake frequency. CONCLUSION: Colombian children and WRA had mUIC well above conventional cutpoints of iodine excess. Whether excessive iodine affects other subpopulations and its functional consequences warrant urgent investigation.

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PURPOSE: The aim of this study was to evaluate the prevalence of thyroid dysfunction in a cohort of healthy individuals in Mexico City, as well as to investigate the potential associations of these results with their estimated iodine intake (EII) as reflected by their 24-hour urinary iodine excretion (24-h UIE). METHODS: From the SALMEX cohort, 683 adults provided an appropriate 24-h urine sample. Thyroid function tests and thyroid antibody concentrations were determined in the participants' sera. We analyzed discrepancies between the commonly used urinary parameters to determine the iodine intake status and the performance of thyroglobulin (Tg) as a biomarker of its status in the adult population. RESULTS: The prevalence of dysthyroidism was high, being similar to other studies. Subclinical hypothyroidism was detected in 5.0% of individuals, clinical hypothyroidism in 1.8% of individuals, and sub-clinical hyperthyroidism in 2.8% of individuals. The median EII was 285 µg/d (IQR 215.0-369.0); 94% of individuals had EII >150 µg/d recommended daily allowance (RDA) in adults. The urinary iodine concentration (UIC) and the UIE had relative biases in their averages of 34.4%. The Tg median was 7.21 ng/mL. The prevalence of increased Tg was 6.15%. There was no correlation between Tg and EII (r= 0.019, p= 0.606). CONCLUSIONS: Thyroid dysfunction was highly prevalent in this population. Our cohort revealed a slight discrepancy between dysthyroidism manifestations and iodine intake markers; the latter represent a population with adequate iodine intake. Further studies are necessary to clearly define the prevalence of thyroid dysfunction as well as the iodine nutritional status in Mexico.

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INTRODUCTION: The level of iodine in breast milk may be inadequate and compromise the health of this, both due to excess and lack, some population groups remain deficient because of the low consumption of iodate salt, because there is an increase in consumption of other sources of iodine, such as supplements and fortified foods. OBJECTIVE: To evaluate the effect of the consumption of fortified foods and nutritional supplements with iodine on maternal milk levels. METHODOLOGY: Systematic review based on the Prism method, using the descriptors provided by DeCS. The reading, selection and analysis of the methodological quality of the articles was done by two researchers independently. RESULTS: From 346 abstracts, 6 were eligible. The median iodination range between the studies ranged from 75 to 600 µg in supplements and 150 and 225 µg in fortified foods with effect on increased iodine concentration of breastmilk (BMIC), achieving the adequacy of the median BMIC in 4 of the 6 studies. CONCLUSION: Iodine ingestion through supplements or fortified foods results in improved iodine levels in breast milk.

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The aim of this work was to systematically obtain quantitative imaging parameters with static and dynamic contrast-enhanced (CE) X-ray imaging techniques and to evaluate their correlation with histological biomarkers of angiogenesis in a subcutaneous C6 glioma model. Enhancement (E), iodine concentration (CI), and relative blood volume (rBV) were quantified from single- and dual-energy (SE and DE, respectively) micro-computed tomography (micro-CT) images, while rBV and volume transfer constant (Ktrans) were quantified from dynamic contrast-enhanced (DCE) planar images. CI and rBV allowed a better discernment of tumor regions from muscle than E in SE and DE images, while no significant differences were found for rBV and Ktrans in DCE images. An agreement was found in rBV for muscle quantified with the different imaging protocols, and in CI and E quantified with SE and DE protocols. Significant strong correlations (Pearson r > 0.7, p < 0.05) were found between a set of imaging parameters in SE images and histological biomarkers: E and CI in tumor periphery were associated with microvessel density (MVD) and necrosis, E and CI in the complete tumor with MVD, and rBV in the tumor periphery with MVD. In conclusion, quantitative imaging parameters obtained in SE micro-CT images could be used to characterize angiogenesis and necrosis in the subcutaneous C6 glioma model.

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Salt iodization is the main public health policy to prevent and control iodine deficiency disorders. The National Salt Iodization Impact Assessment Survey (PNAISAL) was conducted to measure iodine concentration among Brazilian schoolchildren. A survey including 6-14-year-old schoolchildren from public and private schools from all 26 Brazilian states and the Federal District was carried out in the biennia 2008-2009 and 2013-2014. Municipalities, schools, and students were randomly selected. Students were interviewed at school using a standard questionnaire, which included the collection of demographic, educational, weight, height, and 10 mL non-fasting urine collection information. The analyses were weighted according to the population of students per federative unit. The median urinary iodine concentration (MUIC) for the entire sample by region, federative unit per school, and student characteristics, was described from the cutoff points defined by the World Health Organization (severe disability: <20 µg/L, moderate: 20-49 µg/L, mild: 50-99 µg/L, adequate: 100-199 µg/L, more than adequate: 200-299 µg/L, and excessive: >300 µg/L). In total, 18,864 students (95.9% of the total) from 818 schools in 477 municipalities from all federative units were included in this study. Almost 70% were brown skin color, nine-years-old or older, studied in urban schools, and were enrolled in elementary school. The prevalence of overweight/obesity, as measured by body mass index (BMI) for age, was about twice as high compared to nutritional deficits (17.3% versus 9.6%). The MUIC arrived at 276.7 µg/L (25th percentile = 175.5 µg/L and 75th percentile = 399.71 µg/L). In Brazil as a whole, the prevalence of mild, moderate, and severe deficit was 6.9%, 2.6%, and 0.6%, respectively. About one-fifth of the students (20.7%) had adequate iodine concentration, while 24.9% and 44.2% had more than adequate or excessive concentration, respectively. The prevalence of iodine deficits was significantly higher among younger female students from municipal public schools living in rural areas with the lowest BMI. The median urine iodine concentration showed that Brazilian students have an adequate nutritional intake, with a significant proportion of them evidencing overconsumption of this micronutrient.

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El yodo es un elemento esencial para la síntesis de hormonas tiroideas (HT), necesarias para el desarrollo del cerebro. Los grupos más vulnerables a la deficiencia de yodo (DY) son las embarazadas, mujeres lactantes y niños menores de dos años. La ingesta de yodo y el estado nutricional del yodo en la madre lactante, está fuertemente relacionada con la secreción del micronutriente en leche materna (LM). Como la mayor parte del yodo absorbido por el organismo es excretada en orina, la mediana de concentración de yodo urinario (CYU), es el mejor indicador bioquímico empleado para evaluar la situación nutricional del yodo en mujeres lactantes y niños menores de dos años. Con base en la CYU en escolares de la mayoría de los países de Latinoamérica, la ingesta de yodo resultó adecuada. Sin embargo, la suficiencia de yodo en escolares no siempre se corresponde con una adecuada ingesta de yodo en mujeres lactantes. Se ha dedicado escasa atención a las consecuencias adversas de la DY durante la lactancia. En esta corta revisión, se examina la importancia del estado nutricional del yodo en la mujer lactante y se recomienda instaurar su vigilancia y monitoreo a través del análisis de yodo en orina, implementar medidas de intervención apropiadas a fin de contribuir a garantizar un óptimo estado de salud y nutrición en la madre y prevenir la aparición de trastornos por DY en lactantes y niños pequeños.

Iodine is an essential component of thyroid hormones (TH). TH are necessary for brain development. The most susceptible groups to iodine deficiency (ID) are pregnant and lactating women and children under two years of age. Maternal nutritional status and iodine intake strongly affect the amount of this nutrient secreted in breast milk (BM). Most of the iodine absorbed by the body is eventually excreted in the urine. For this reason, the median urinary iodine concentration (UIC) is the best indicator to assess the iodine nutritional status of lactating women and children less than two years of age. With base on the UIC in most of Latin American school-aged children, iodine intake was normal. However, iodine sufficiency in school age children not always corresponds with an adequate intake in lactating mothers. Little attention has been paid to the adverse consequences of ID during lactation. The objective of this short review was to examine the importance of iodine nutritional status in lactating women. We recommend to establish surveillance and monitoring of iodine status in lactating women through urine iodine levels, to implement measures to help promote an optimal health and nutrition of the mother to prevent iodine deficiency disorders (IDD) of infants and young children.

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Mexico is considered as a nutritional transition country with a high prevalence of overweight and obesity, and recent studies have reported a high iodine intake in children. Both high iodine intake and obesity have been associated with thyroid dysfunction. Our aim was to assess iodine and salt intake and thyroid function in Mexican schoolchildren with normal weight and obesity. A cross-sectional study was performed during 2012-2013 in schoolchildren from Queretaro, Mexico. Six hundred seventy-eight schoolchildren were evaluated to obtain nutrition status, urinary iodine concentration (UIC) and thyroid volume (TVol). The prevalence of overweight and obesity was 47.3 %, the median UIC was 428 µg/L and TVol was normal in all schoolchildren; however, obese girls had a higher TVol than normal weight at the age of 8, 10 and 12 years. A subsample of schoolchildren was divided in 6-8 and 9-12-year-old groups, in order to compare thyroid function (thyrotropin, free T4, and anti-thyroid antibodies); iodine and salt intake were estimated with 24-h urinary samples. No differences in thyroid function were observed in both age groups. In the 6-8-year-old group, obese schoolchildren had higher iodine intake than normal-weight children (415.5 vs. 269.1 µg/day, p < 0.05), but no differences in salt intake. In contrast, in the 9-12-year-old group, obese schoolchildren had higher salt intake than normal-weight children (6.2 vs. 3.8 g/day, p < 0.05), but no differences in iodine intake. Dietary patterns could explain the differences between both age groups. Further studies are needed to identify the main sources of iodine intake in Mexican populations.

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OBJECTIVE AND METHODS: To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. RESULTS: 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (< 15 ppm). Medians of UIC per school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p < 0.005), height SDS (r = 0.41; p < 0.05), and overweight and obesity prevalence (r = 0.41; p < 0.05). Medians of UIC per school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p < 0.05). Best multiple regression models showed that BMI SDS and height were significantly related with UIC (p < 0.05). CONCLUSIONS: There is coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

OBJETIVO E MÉTODOS: Estimar a concentração de iodo urinário (CIU) mediana e correlacioná-la com os indicadores de nutrição geral e com o índice de desigualdade social (IDS) de 50 escolas estaduais de ensino fundamental de 10 municípios do estado de Querétaro, no México. RESULTADOS: Utilizou-se um total de 1.544 crianças e encontrou-se uma ingestão acima das necessidades de iodo (CIU mediana de 297 µg/L). O nível de iodo determinado foi deficiente, adequado, mais do que adequado e excessivo em 2, 4, 19 e 25 escolas, respectivamente. Setenta e sete por cento de amostras de sal de mesa mostraram uma quantidade de iodo adequada (20-40 ppm), enquanto 9,6% das amostras tinham um teor de iodo baixo (< 15 ppm). As medianas de CIU por escola foram correlacionadas positivamente com as medianas do índice de massa corporal (IMC) usando o desvio-padrão da contagem (DP) (r = 0,47; p < 0.005), o DP da altura (r = 0,41; p < 0.05) e a prevalência de sobrepeso e de obesidade (r = 0,41; p < 0,05). As medianas de CUI por escola foram correlacionadas negativamente com a prevalência de desnutrição (r = -0.39; p = 005) e com o índice de desigualdade social (r = -0.36; p < 0,05). Os melhores modelos de regressão múltipla mostraram que a DP do IMC e a altura foram relacionados significativamente com a CIU (p < 0,05). CONCLUSÃO: Existe uma convivência entre os dois extremos de ingestão de iodo (insuficiente e excessiva). Em nosso conhecimento, a correlação positiva entre a CIU, o excesso de peso e a obesidade não foi descrita anteriormente e poderia ser explicada pela disponibilidade e consumo de alimentos ou refeições ricos(as) em energia e sal iodado.

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Introducción: El año 2000 se determinó que la mediana de la concentración urinaria de yodo (CUI) en escolares de educación básica de Calama estaba en 2600 ug/L, valor muy elevado, el que descendió a 487 ug/L el año 2004 después de reducir los niveles oficiales de yodación de la sal de 100 ppm a 40 ppm el año 2000. Objetivo: Investigar la nutrición de yodo en escolares de Calama, 12 años después del cambio de legislación. Sujetos y métodos: 332 escolares de ambos sexos de una escuela municipal de educación básica de Calama fueron evaluados sobre la prevalencia de bocio mediante la palpación de la glándula tiroides; al 22% de los mismos (72) se les evaluó la nutrición de yodo mediante la determinación de CUI en muestras casuales de orina por espectrofotometría. Se recolectaron 58 muestras de sal de consumo humano, seleccionadas aleatoriamente en locales comerciales, comedores de la escuela y en los hogares de los escolares, para determinar su contenido de yodo por la técnica de almidón. Adicionalmente, en todos los escolares se registró peso, talla e IMC. Resultados: Se encontró una prevalencia de bocio de 8.2%, todos del grado 1. La mediana de la concentración urinaria de yodo fue 448 ug/L. La concentración de yodo en la sal fue 31,4 ± 17.8 ppm, valor dentro de los estándares oficiales establecidos en el Reglamento Sanitario de los Alimentos (RSA) del Ministerio de Salud de Chile. Comentarios y conclusiones: Los resultados muestran un leve aumento en la prevalencia de bocio y que persiste una alta CUI en escolares de Calama, probablemente debido a una excesiva ingesta de yodo, no obstante que el promedio de contenido de yodo en la sal para consumo humano estuvo dentro del rango recomendado por OMS-UNICEF-ICCIDD (20-40 ppm). Estos hallazgos plantean la necesidad de investigar otras probables fuentes de ingesta de yodo, como causa del exceso de yodo que persiste en Calama.

Introduction: In the year2000 it was determined that the median of the urinary iodine concentration (UIE) in primary school children from Calama was 2600 ug/L, a very high level which went down to 487 ugI/L in 2004, after the standards of the Food Sanitary Regulation were scaled down from 100 ppm to 40 ppm in the year 2000. Objective: To search the current iodine nutrition in school children of Calama, 12 years after the change in the legislation. Subjects and methods: 332 primary school children from Municipal School D-48 ofthe City ofCalama were assessed in relation to their prevalence of goiter determined through palpation of the thyroid gland. In 22% ofthem (72 children), UIE was determined by spectrophotometry. 58 samples ofsalt for human consumption saltwere randomly collected from local shops, school canteens and from the children's homes to determine their iodine concentration through the starch technique. In addition, the school children were measured and weighed to determine the adequacy of their height and Body Mass Index (BMI). Results: An 8.2% prevalence ofgoiter was found; all were grade 1. The iodine concentration in the salt was 31.4 ± 17.8 in the 58 samples analyzed, the average met the adequate range of the current Food Sanitary Regulation (FSR) of Health Ministry of Chile. Conclusion and comments: A non significant increase in the prevalence ofgoiter was found, the average of UIE continue being high, possible due to an excessive intake ofiodine, nevertheless average iodine concentration in the salt for human consumption is within de recommended range by WHO-UNICEF-ICCIDD (20-40 ppm). These findings prompt to search another sources of iodine intake, as an explanation of the persistent elevation of UIE in these children.

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