Goiter determination

International assistance would be most needed for assesment, monitoring and surveillance. Minimum 4-5 laboratories for iodine determination should be implemented in different part of the country. Training courses should be organized both for ultrasound goiter determination and urine iodine measurement. 

Rubidium metal and its salts bave very few commercial apphcations. They are used in research involving magnetohydrodynamics and thermoionic experiments. Rubidium is used in pbotocells. The metal also is a getter of oxygen in vacuum tubes. The beta-emitter rubidium -87 is used to determine age of some rocks and minerals. Radioisotopes of rubidium have been used as radioactive tracers to trace the flow of blood in the body. The iodide salt treats goiters. Rubidium salts are in pharmaceuticals as soporifics, sedatives, and for treating epilepsy. 

Walker JS, Levy G (1989) Induction of experimental thyroid dysfunction in rats with implantable pellets of thyroxine or propylthiouracil. J Pharmacol Meth 21 223-229 Wiberg GS, Carter JR, Stephenson NR (1964) The effects of various goitrogens on the determination of the relative potency of thyroid by the goiter prevention assay. Acta Endocrin 45 370-380... 

Despite this variety of clinical findings, frank hypothyroidism and clinical goiter actually are rare sequelae of lithium therapy. However, it is difficult to predict lithium-induced thyroid dysfunction, and regular TRH determinations should be carried out to identify any late-developing disorder (43). 

Although trace amounts of supplemental iodine (50-100 rg/kg feed dry matter) effectively prevent goiter, they are currently difficult to detect and measure accurately. More sensitive methods to determine the iodine content of feed, including matrix disintegration, are required. Methods with the potential to reliably detect < 20 ig iodine/kg should be critically evaluated. The reliability of the reported feed iodine content should be questioned in animal studies if goiter or other symptoms of iodine deficiency are reported, despite the use of diets thought to contain more than 100 xg detected iodine/kg... 

Serum thyroid-stimulating hormone (TSH) and thyroid hormone levels should be measured in any patient with a goiter to determine the hormonal status. TSH concentrations increase with age, but the levels remain within the normal range in the healthy population throughout life up to 100 years of age (Canaris et al., 2000 Mariotti et al, 1995). See Chapter 106 by Diez and Iglesias on Hypothyroidism in the Middle Aged and Elderly Clinical Aspects for details of thyroid hormone changes in the elderly. Serum calcitonin levels are not needed unless there is a family history of medullary thyroid cancer or multiple endocrine neoplasia (MEN) type 2. 

Until the 1990s, total goiter prevalence (TGP) in school-age children was the primary indicator for the assessment of functional consequences of iodine deficiency in the population (WHO et al., 2001). Thyroid size was traditionally determined by palpation, but the reliability of this method is limited by high inter-observer and intra-observer variations. The measurement of thyroid size by ultrasound has therefore been an important step in the detection of mild-to-moderate iodine deficiency. International reference values for normal thyroid size are now available from iodine-sufficient children (Zimmermann et al., 2004). Because TGP is not a sensitive indicator of recent changes in iodine status in the... 

In 1990, the levels of endemic goiter were monitored, and its prevalence was estimated in 13 municipalities of five Brazilian states. This study showed the need for updating the data on endemic iodine deficiency at a national level, associating the study on the prevalence of goiter with the determination of iodine urinary excretion levels to ascertain the actual size of the problem, and with the levels of iodine in the salt consumed at the regional level (Esteves, 1997). 

There are indications that lymphocytic thyroiditis is increasing in incidence in all parts of the world, particularly in children (H28). This may be a reflection of increasing awareness of the condition rather than a true increase in its frequency. It is possibly the most common cause of goiter in children. There is a strong possibility that it is genetically determined and sometimes secondary to a dyshormonogenetic defect, particularly the formation of an abnormal iodinated protein (D3). 

Navarra (Pyrenees) and the Canary Islands. The approximately 150 papers published between 1945 and 1987 include an increasing proportion of studies using international criteria for the definition of goiter size, and more modern analytical procedures. Determinations of plasma PBI were already applied by us to the La Alpujarra endemia in 19547. Experimental work in laboratory animals was initiated by Ortiz de Landcizuri and his group, including transfer of rats to La Alpujarra those fed local food developed goiter . 

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