Iodine intake and status during pregnancy and lactation before and after government initiatives to improve iodine status, in Palmerston North, New Zealand: a pilot study

Iodine is a micronutrient, which is essential for the synthesis of thyroid hormones. Thyroid hormones play a major role in the development of different functional components in different stages of life. The relationship between iodine intake level of a population and occurrences of thyroid disorders U-shaped with an increase from both low and high iodine intake. Iodine deficiency disorders (IDDs) are a major health problem worldwide in all age groups, but infants, school children, and pregnant and lactating women are vulnerable. During pregnancy and lactation, the fetus and infants are sensitive to maternal iodine intake. Even mild iodine deficiency may lead to irreversible brain damage during this period. A main cause of IDDs of neonates and infants is maternal iodine deficiency. Universal salt iodization strategy has been initiated by the World Health Organization and United Nation International Children Emergency Fund by the year 1993 for correction and prevention of iodine deficiency. Excessive iodine causes hypothyroidism, iodine-induced hyperthyroidism and autoimmune thyroid diseases. Iodine deficiency and excessive iodine, both cause goiter. There are many indicators for assessing the IDDs, such as measurement of thyroid size by palpation or ultrasonography, serum thyroid stimulating hormone, and thyroglobulin but these are less sensitive, costly and sometimes interpretation is difficult. Urinary iodine concentration (UIC) is a well-accepted, cost-efficient, and easily obtainable indicator of iodine status. Since the majority of iodine absorbed by the body is excreted in the urine, it is considered a sensitive marker of current iodine intake and can reflect recent changes in iodine status. Iodine requirements are greatly increased during pregnancy and lactation, owing to metabolic changes. During intrauterine life, maternal iodine is the only source of iodine for a fetus. UIC determines the iodine status of pregnant and lactating women. Breast milk is the only source of iodine for exclusively breastfed neonates and infants. Breast milk iodine concentration can be determined by UIC. UIC predicts the adverse health consequences of excessive iodine intake such as goiter, hypothyroidism, and hyperthyroidism. This review presents that iodine status in different groups of a population can be determined by UIC which will be helpful in assessing the iodine status in a community, finding out the cause of thyroid disorders, to predict the risk of adverse health effects of iodine deficiency and excessive iodine, and in making plan for iodine supplementation.Mediscope Vol. 5, No. 2: Jul 2018, Page 30-35

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Vitamin D3 supplementation in adults with bronchiectasis: A pilot study

Chronic Respiratory Disease ◽

10.1177/1479972318761646 ◽

2018 ◽

Vol 15 (4) ◽

pp. 384-392 ◽

Cited By ~ 6

Author(s):

Jim Bartley ◽

Jeff Garrett ◽

Carlos A Camargo ◽

Robert Scragg ◽

Alain Vandal ◽

...

Keyword(s):

Vitamin D ◽

New Zealand ◽

Pilot Study ◽

Respiratory Infections ◽

Vitamin D Supplementation ◽

Hydroxyvitamin D ◽

Cell Counts ◽

Before And After ◽

Related Quality ◽

Vitamin D3 Supplementation

Vitamin D supplementation prevents acute respiratory infections and, through modulating innate and adaptive immunity, could have a potential role in bronchiectasis management. The primary aims of this pilot study were to assess serum 25-hydroxyvitamin D (25(OH)D) levels in New Zealand adults with bronchiectasis, and their 25(OH)D levels after vitamin D3 supplementation. Adults with bronchiectasis received an initial 2.5 mg vitamin D3 oral loading dose and 0.625 mg vitamin D3 weekly for 24 weeks. The primary outcome was serum 25(OH)D levels before and after vitamin D3 supplementation. Secondary outcomes (time to first infective exacerbation, exacerbation frequency, spirometry, health-related quality of life measures, sputum bacteriology and cell counts and chronic rhinosinusitis) were also assessed. This study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12612001222831). The initial, average 25(OH)D level was 71 nmol/L (95% confidence interval (CI): [58, 84]), rising to 218 nmol/L (95% CI: [199, 237]) at 12 weeks and 205 nmol/L (95% CI: [186, 224]) at 24 weeks. The initial serum cathelicidin level was 25 nmol/L (95% CI: [17, 33]), rising to 102 nmol/L (95% CI: [48, 156]) at 12 weeks and 151 nmol/L (95% CI: [97, 205]) at 24 weeks. Over the 24-week study period, we observed statistically significant changes of 1.11 (95% CI: [0.08, 2.14]) in the Leicester Cough Questionnaire and −1.97 (95% CI: [−3.71, −0.23]) in the Dartmouth COOP charts score. No significant adverse effects were recorded. Many New Zealand adults with bronchiectasis have adequate 25(OH)D levels. Weekly vitamin D3 supplementation significantly improved 25(OH)D levels.

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Iodine status in breastfeeding women and their infants in New Zealand

Proceedings of The Nutrition Society ◽

10.1017/s0029665120000658 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Ying Jin ◽

Jane Coad ◽

Louise Brough

Keyword(s):

New Zealand ◽

Inductively Coupled Plasma ◽

Iodine Concentration ◽

Nutritional Knowledge ◽

Sample Collection ◽

Iodine Status ◽

Spot Urine ◽

Hormone Synthesis ◽

Supplement Use ◽

Before And After

AbstractIodine is an essential micronutrient in thyroid hormone synthesis and physical and mental development. Iodine deficiency has historically been a problem in New Zealand. Two government initiatives were introduced: 1) mandatory fortification of all bread (except organic) with iodised salt (2009); 2) provision of a subsidised iodine supplement for all pregnant and breastfeeding women (2010). Since these initiatives, the majority of adults and children have achieved adequate iodine status. However, iodine status among breastfeeding women and their infants is unknown. This observational follow-up cohort study recruited 87 breastfeeding women, aged 16 years and over, with a healthy term singleton infant, in the Manawatu region, New Zealand. Women were recruited at 3 months postpartum; and followed up at 6 and 12 months postpartum. A maternal questionnaire investigated supplement use before and after delivery, iodine nutritional knowledge, and demographic information. Maternal spot urine, breastmilk, and infant spot urine samples were collected and iodine concentrations determined using inductively-coupled plasma mass spectrometry. Iodine-containing supplement use was recorded in the 24 hours before biological sample collection. Shapiro-Wilk test was used to check the normality of the data. Iodine data were analysed using non-parametric Mann Whitney U test (2-tailed).Thirty-five (40%) women used iodine-containing supplements during breastfeeding. Median urine iodine concentration (UIC) was 82 (46, 157) μg/L, below the WHO cut-off value of 100 μg/L for breastfeeding women. Median infant UIC was 115 (69, 182) μg/L, above the WHO cut-off value of 100 μg/L. Median maternal UIC was significantly higher for supplement users than non-users (111(44, 240) vs 62(42, 102) μg/L; p = 0.021]. Median infant UIC was significantly higher for supplement users than non-users (150(97, 193) vs 86(53, 171) μg/L; p = 0.045]. Median breastmilk iodine concentration (BMIC) was 69 (52, 119) μg/L, lower than recommended (75 μg/L). Median BMIC was significantly higher for supplement users than non-users [83(67, 168) vs 62(48, 82) μg/L; p = 0.000]. Overall, iodine status within this sample of breastfeeding women remains inadequate at 3 months postpartum. Users of iodine containing supplements and their infants achieved recommended iodine UIC concentrations; however, non-users and their infants had inadequate status. Despite recommendations that all breastfeeding women use iodine supplements, supplement use was low (only 40%). Further work is require to investigate if current iodine status affects thyroid function. Alternative strategies are also required to ensure breastfeeding women and their infants have adequate iodine.

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A pilot study on the effect of ulipristal acetate on myoma angiogenesis, measured by 2D ultrasound and VEGF serum levels

10.36811/ojgor.2020.110015 ◽

2020 ◽

pp. 19-29

Author(s):

Patricia Diaz Ortega ◽

Manuel García Manero

Keyword(s):

Pilot Study ◽

Power Doppler ◽

Uterine Fibroids ◽

Premenopausal Women ◽

Serum Levels ◽

Ulipristal Acetate ◽

Before And After ◽

Angiogenesis Process ◽

2D Ultrasound ◽

Average Size

Introduction: Symptomatic uterine fibroids can cause symptoms that can be disabling. There are many treatments, including ulipristal acetate, whose role in reducing symptoms and decreasing the size of the fibroid is well known. With this preliminary study, we also try to evaluate the correlation between myoma vascularization measured by ultrasound (Power Doppler 2D) and serum VEGF levels, before and after treatment with ulipristal acetate; in patients diagnosed with symptomatic uterine fibroids. Materials and Methods: A preliminary, prospective observational pilot study was designed. Twenty-four premenopausal women, diagnosed with symptomatic uterine fibroids, were included and all of them completed the study. Four cycles of ulipristal acetate were administered according to the dose and indications specified in the data sheet. In order to assess the influence of this treatment on the angiogenesis process of the fibroids, measurements of VEGF serum levels were made and their vascularization was assessed by means of 2D power doppler ultrasound; at the beginning and the end of treatment. In addition, several determinations of the same parameters were made throughout the successive visits. Endpoints were defined as the decrease in VEGF levels from previous levels, the decrease in myoma vascularization on ultrasound, and the reduction in myoma size. Result: 24 patients who met the inclusion criteria were enrolled (n=24). The average size of myomas was reduced from 45,08 ? 24,02mm to 29?16,96mm after treatment. The average VEGF serum level significantly decreased after the first treatment cycle (from 147,17 ? 153,51 pg/ml to 102,04 ? 186,08pg/ml). Vascularization of myomas after treatment with ulipristal acetate was analyzed, and a significantly decrease was achieved in 83,3% of cases. Conclusion: There is a correlation between myoma vascularization and treatment with Ulipristal acetate. SPRMs may provide effective treatment for women with symptomatic fibroids by two ways: supports selective progesterone receptor modulators and reduced angiogenesis. Keywords: Angiogenesis; Ulipristal Acetate; Uterine fibroids; VEGF

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Iodine status of Indigenous and non‐Indigenous young adults in the Top End, before and after mandatory fortification

The Medical Journal of Australia ◽

10.5694/mja2.12031 ◽

2018 ◽

Vol 210 (3) ◽

pp. 121-125 ◽

Cited By ~ 2

Author(s):

Gurmeet R Singh ◽

Belinda Davison ◽

Gary Y Ma ◽

Creswell J Eastman ◽

Dorothy EM Mackerras

Keyword(s):

Young Adults ◽

Iodine Status ◽

Before And After

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THU0642-HPR EVOLUTION OF THE PERCEPTIONS OF RA PATIENTS AFTER EDUCATION PATIENT SESSION TEACHING METHOTREXATE SELF-INJECTION A PROSPECTIVE PILOT STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5505 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 566.1-566

Author(s):

S. Afilal ◽

H. Rkain ◽

B. Berchane ◽

J. Moulay Berkchi ◽

S. Fellous ◽

...

Keyword(s):

Pilot Study ◽

Patient Education ◽

Median Duration ◽

Large Scale ◽

Education Session ◽

Prospective Pilot Study ◽

Mean Delay ◽

Lack Of Information ◽

Level Of Satisfaction ◽

Before And After

Background:Methotrexate is a gold standard for treatment of RA. In our context, RA patients prefer to be injected by paramedics rather than self-injecting. This can be explained by patients’ bad perceptions of self-injection or lack of information. Appropriate self-injection education can therefore be an important element in overcoming these obstacles and improving disease self-management.Objectives:Compare the RA patients’ perceptions on methotrexate self-injection before and after a patient education session.Methods:Prospective pilot study that included 27 consecutive patients (81.5% female, mean age 44.4 years, illiteracy rate 40.7%) with RA (median duration of progression of 4 years, mean delay in referral for specialist of 6 months, median duration of methotrexate use of 1 year). The patients benefited from an individual patient education session to learn how to self-inject with methotrexate subcutaneously. The patient education session was supervised by a nurse and a rheumatologist with a control a week later. Perceptions of the reluctance to self-inject and the difficulties encountered by patients were assessed before the patient education session, after the 1st and 2nd self-injection of methotrexate using a 10 mm visual analog scale. Patients also reported their level of satisfaction (10 mm VAS) after the 1st and 2nd self-injection.Results:The mean duration of patient education session is 13 min.Table I compares the evolution of the degrees of reluctance to self-injection, the difficulties encountered, and the satisfaction experienced by the patients.Table 1.Evolution of RA patients’ perceptions on the methotrexate self-injection. (N = 27)BeforeAfter the 1stself-injectionAfter the 2end self-injectionpVAS reluctance (0-10mm)6,5 ± 3,62,2 ± 2,91,0 ± 2,3<0,0001VAS difficulty (0-10mm)7,5 ± 2,62,5 ± 2,71,0 ± 1,9<0,0001VAS satisfaction (0-10mm)-8,9 ± 1,89,5 ± 1,50,002Conclusion:This study suggests the effectiveness of a methotrexate self-injection patient education session in RA patients. It also highlights the value of patient education in rheumatologic care. A large-scale study is necessary to better interpret and complete these preliminary results from this pilot study.Disclosure of Interests:None declared

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Plasma Exosomal miRNA Levels after Radiotherapy Are Associated with Early Progression and Metastasis of Cervical Cancer: A Pilot Study

Journal of Clinical Medicine ◽

10.3390/jcm10102110 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2110

Author(s):

Oyeon Cho ◽

Do-Wan Kim ◽

Jae-Youn Cheong

Keyword(s):

Cervical Cancer ◽

Pilot Study ◽

Biological Functions ◽

Patients With Cancer ◽

Initial Stage ◽

Exosomal Mirnas ◽

Early Progression ◽

Before And After ◽

Microenvironmental Factors ◽

Exosomal Mirna

Plasma exosomal miRNAs are key regulators of cell-cell interactions associated with several biological functions in patients with cancer. This pilot study aimed to investigate the log2 fold change (log2FC) of the expression of exosomal miRNAs and related mRNAs in the blood of patients with cervical cancer to identify prognostic markers better than those currently available. We sequenced plasma exosomal RNA from 56 blood samples collected from 28 patients with cervical cancer, who had been treated with concurrent chemoradiotherapy (CCRT). Changes in the expression of miRNAs and mRNAs before and after CCRT were represented as log2FC. Their biological functions were studied by miRNA-mRNA network analysis, using ingenuity pathway analysis, after the selection of two groups of miRNAs, each associated with early progression (EP) and metastasis, also described as initial stage. Seven patients experienced EP, three of whom died within four months after progression. Reduced levels of miR-1228-5p, miR-33a-5p, miR-3200-3p, and miR-6815-5p and increased levels of miR-146a-3p in patients with EP revealed unresolved inflammation, with accompanying increased expression of PCK1 and decreased expression of FCGR1A. Increased levels of miR-605-5p, miR-6791-5p, miR-6780a-5p, and miR-6826-5p and decreased levels of miR-16-1-3p (or 15a-3p) were associated with the degree of metastasis and led to the systemic activation of myeloid, endothelial, and epithelial cells, as well as neurons, phagocytes, and platelets. Log2FCs in the expression of miRNAs and mRNAs from plasma exosomes after CCRT are associated with EP and metastasis, reflecting unresolved inflammation and systemic microenvironmental factors, respectively. However, this study, supported by preliminary data insufficient to reach clear conclusions, should be verified in larger prospective cohorts.

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FRI0514 USE OF OPIATE FOR HIP AND KNEE OSTEOARTHRITIS BEFORE AND AFTER JOINT REPLACEMENT SURGERY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1359 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 856.1-856

Author(s):

C. Lao ◽

D. Lees ◽

D. White ◽

R. Lawrenson

Keyword(s):

New Zealand ◽

Knee Osteoarthritis ◽

Knee Replacement ◽

Charlson Comorbidity Index ◽

Hip Osteoarthritis ◽

Index Score ◽

Charlson Comorbidity Index Score ◽

Joint Replacement Surgery ◽

Before And After ◽

Comorbidity Index

Background:Osteoarthritis of the hip and knee is one of the most common causes of reduced mobility. It also causes stiffness and pain. Opioids can offer pain relief but is usually used for severe acute pain caused by major trauma or surgery. The use of opioids for relief of chronic pain caused by arthritis has increased over the last few decades.[1]Objectives:This study aims to investigate the use of strong opiates for patients with hip and knee osteoarthritis before and after joint replacement surgery, over a 13 years period in New Zealand.Methods:This study included patients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgeries in 2005-2017 in New Zealand. These records were identified from the National Minimum Dataset (NMD). They were cross referenced with the NZJR data to exclude the admissions not for primary hip or knee replacement surgeries. Patients without a diagnosis of osteoarthritis were excluded.The PHARMS dataset was linked to the NMD to identify the use of strong opiates before and after surgeries. The strong opiates available for community dispensing in New Zealand and included in this study are: dihydrocodeine, fentanyl, methadone, morphine, oxycodone and pethidine. Use of opiate within three months prior to surgery and within 12 months post-surgery were examined by gender, age group, ethnicity, Charlson Comorbidity Index score and year of surgery. Differences by subgroup was examined with Chi- square test. Logistic regression model was used to calculate the adjusted odds ratios of strong opiate use before and after surgery compared with no opiate use.Results:We identified 53,439 primary hip replacements and 50,072 primary knee replacements with a diagnosis of osteoarthritis. Of patients with hip osteoarthritis, 6,251 (11.7%) had strong opiate before hip replacement surgeries and 11,939 (22.3%) had opiate after surgeries. Of patients with knee osteoarthritis, 2,922 (5.8%) had strong opiate before knee replacement surgeries and 15,252 (30.5%) had opiate after surgeries.The probability of patients with hip and knee osteoarthritis having opiate decreased with age, increased with Charlson comorbidity index score, and increased over time both before and after surgeries. Male patients with hip and knee osteoarthritis were less likely to have opiate than female patients both before and after surgeries. New Zealand Europeans with hip and knee osteoarthritis were more likely to receive opiate than other ethnic groups prior to surgeries, but were less likely to have opiate than Asians post-surgeries.Patients who had opiate before surgeries were more likely to have opiate after surgeries than those who did not have opiate before surgeries. The odds ratio was 8.34 (95% confidence interval (CI): 7.87-8.84) for hip osteoarthritis and 11.94 (95% CI: 10.84-13.16) for knee osteoarthritis after adjustment for age, gender, ethnicity, year of surgery and Charlson comorbidity index score. Having opiate prior to surgeries also increased the probability of having opiate for 6 weeks or more after surgeries substantially. The adjusted odds ratio was 21.46 (95% CI: 19.74-23.31) for hip osteoarthritis and 27.22 (95% CI: 24.95-29.68) for knee osteoarthritis.Conclusion:Preoperative opiate holidays should be encouraged. Multiple strategies need to be used to develop analgesic plans that allow adequate rehabilitation, without precipitating a chronic opiate dependence. Clinicians would also benefit from clear guidelines for prescribing strong opiates.References:[1] Nguyen, L.C., D.C. Sing, and K.J. Bozic,Preoperative Reduction of Opioid Use Before Total Joint Arthroplasty.J Arthroplasty, 2016.31(9 Suppl): p. 282-7.Disclosure of Interests:None declared

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Gamma entrainment frequency affects mood, memory and cognition: an exploratory pilot study

Brain Informatics ◽

10.1186/s40708-020-00119-9 ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

Ryan L. S. Sharpe ◽

Mufti Mahmud ◽

M. Shamim Kaiser ◽

Jianhui Chen

Keyword(s):

Pilot Study ◽

Correlation Analysis ◽

Negative Correlation ◽

Cognitive Abilities ◽

Statistical Significance ◽

Assessment Scores ◽

Frequency Group ◽

Before And After ◽

Mood Score ◽

40 Hz

AbstractHere we provide evidence with an exploratory pilot study that through the use of a Gamma 40 Hz entrainment frequency, mood, memory and cognition can be improved with respect to a 9-participant cohort. Participants constituted towards three binaural entrainment frequency groups: the 40 Hz, 25 Hz and 100 Hz. Participants attended a total of eight entrainment frequency sessions twice over the duration of a 4-week period. Additionally, participants were assessed based on their cognitive abilities, mood as well as memory, where the cognitive and memory assessments occurred before and after a 5-min binaural beat stimulation. The mood assessment scores were collected from sessions 1, 4 and 8, respectively. With respect to the Gamma 40 Hz entrainment frequency population, we observed a mean improvement in cognitive scores, elevating from 75% average to 85% average upon conclusion of the experimentation at weak statistical significance ($$\alpha$$ α = 0.10, p = 0.076). Similarly, memory score improvements at a greater significance ($$\alpha$$ α = 0.05, p = 0.0027) were noted, elevating from an average of 87% to 95%. In pertinence to the mood scores, a negative correlation across all populations were noted, inferring an overall increase in mood due to lower scores correlating with elevated mood. Finally, correlation analysis revealed a stronger R$$^2$$ 2 value (0.9838) within the 40 Hz group between sessions as well as mood score when compared across the entire frequency group cohort.

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Iodine Excretion and Intake in Women of Reproductive Age in South Australia Eating Plant-Based and Omnivore Diets: A Pilot Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073547 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3547

Author(s):

Jane S. Whitbread ◽

Karen J. Murphy ◽

Peter M. Clifton ◽

Jennifer B. Keogh

Keyword(s):

Pilot Study ◽

Urinary Iodine ◽

Group Versus ◽

Iodine Intake ◽

Reproductive Age ◽

World Health ◽

Urinary Iodine Concentration ◽

Women Of Reproductive Age ◽

Increased Risk ◽

Iodine Excretion

Women consuming a strictly vegan/plant-based diet may be at increased risk of low iodine intake due to avoidance of animal products containing iodine. The aim of this pilot study was to determine the iodine excretion and intake in women consuming vegan/plant based diets compared with women consuming omnivore diets. Fifty-seven women (n = 31 plant-based, n = 26 omnivores), provided two spot urine samples to assess urinary iodine concentration (UIC). Two days of dietary intake were also recorded by participants. As the data were not normally distributed results are reported as median (IQR). UIC was significantly different between groups, 44 (26–66) µg/L in the vegan/plant-based group versus 64 (40–88) µg/L in omnivores (p < 0.05). UIC did not meet the >100 µg/L level recommended by the World Health Organization. Iodine intake was also significantly different, 78 (62–91) µg/day in the vegan/plant-based group and 125 (86–175) µg/day in the omnivores (p = 0.000). Iodine intake and bread intake were correlated with iodine excretion (CC 0.410–4.11, p = 0.003). These data indicate iodine insufficiency in both groups of women as the median values were below the minimum WHO recommendation. A larger study assessing iodine excretion in the Australian women of reproductive age who are not pregnant or breastfeeding is needed to confirm these findings.

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