Effect of iodine-containing antiseptics on urine iodine levels of surgical staff after iodization

BackgroundThe routine use of topical iodinated antiseptic could be a possible cause of iodine contamination. This study was aimed to determine urinary iodine status of operation-room staff who routinely use iodine-containing antiseptics for cleansing of the hands after salt iodization.Materials and methodsThe study included 40 operation-room staff who use surgical hand-scrub solutions. Participants applied an iodized brush for a minimum of three times a day on weekdays and were iodine-free on the weekends. Morning urine samples from all volunteers to analyze the urinary iodine concentration (UIC) twice a week. Modified microplate method of Sandell-Kolthoff reaction used to measure UIC.ResultsThe UICs were significantly higher on Friday (median 194 μg/L (70–396 μg/L)) compared to the Monday concentrations (median 125 μg/L (62–264 μg/L), p < 0.001). Mild iodine deficiency occurred in 32.5% of the subjects on Monday, in 5% on Friday. On Monday, there were no subjects with UIC > 300 μg/L, but on Friday, 7.5% of the subjects had UIC > 300 μg/L.ConclusionDespite both the use of iodized antiseptic solution and mandatory iodization, operation-room staff had only median iodine levels with low risk of iodine intoxication.

A Study on Hypothyroidism in a School for the Mentally Retarded in Bandung

A study was made on 114 pupils from a school for the mentally retarded in Bandung. In 50 subjects the length ratio between the upper and the lower segment of the body were more than one; of 44 subjects (32 debils, 11 imbecils, 1 borderline debil-imbecil) we found 2 with hypertelorism, 1 with dry and rough skin, and 1 with gross and fine motor abnormalities. Dental development and bone ages were within normal limits. No rise in serum cholesterol and changes in NTR (Normalized Thyroxine Ratio) were found. T4 (thyroxine) values were within normal limits. Radioactive iodine uptake and scanning of 42 subjects showed hyperplasia in 32 and euthyroidism in 5 subjects. Three subjects suggested a possible iodine contamination, 2 subjects with uptake of more than 50%, one of them showed adenoma (toxic?) on scanning; on the other one scanning was not done. Hypothyroidism was not found; 32 subjects which showed hyperplasia were suggestive of active thyroid. Further studies should be done in another sample of population to trace the problems of hypothyroidism in childhood.

Risk of iodine-induced thyrotoxicosis after coronary angiography: an investigation in 788 unselected subjects

In this study, the risk of iodine-induced thyrotoxicosis in unselected patients from an iodine-deficient area was investigated. The patients were consecutively enrolled. Thyroid hormone values and urinary iodine excretion were determined before, as well as 1, 4 and 12 weeks after iodine contamination by coronary angiography. Two of 788 unselected patients developed hyperthyroidism within 12 weeks. The two patients did not belong to a risk group for iodine-induced thyrotoxicosis (i.e. old people, patients with goiter or possible thyroid autonomy, low TSH). Both patients had normal TSH levels at baseline and ultrasound of the thyroid was without evidence of nodules. The study shows that in euthyroid unselected patients from an iodine-deficient area short-term iodine contamination by contrast media rarely leads to hyperthyroidism. On account of these facts, prophylactic therapy, e.g. by perchlorate or thiamazole, is not generally recommended, because the risk of side-effects is perhaps even greater than the risk of iodine-induced thyrotoxicosis.

Nativer 99mTc-Uptake in der Differentialdiagnostik von unauffälliger Schilddrüse, Struma mit Euthyreose und Schilddrüsenautonomie in einem Jodmangelgebiet

Global TcTU was determined in 568 patients without any specific thyroid drug intake - 54 with normal thyroid, 274 with goitre and euthyroidism and 240 with thyroid autonomy. 57 patients with autonomy and overt hyperthyroidism were the only group with TcTU values significantly higher than normals. Common to all groups was a large scatter of the TcTU values. In 332, the effects of individual iodine supply were studied by measuring the iodine concentration in spot urine samples. There was a significant inverse correlation between the TcTU values and the urinary iodine excretion in the groups of normal thyroids and of goitres with euthyroidism. In the group with autonomy an effect of iodine supply could only be seen in cases of greatly increased urinary iodine excretion, resulting in very low TcTU values. Out of 20 patients with autonomy and iodine contamination, only 4 showed overt hyperthyroidism. The large scatter of TcTU values in all groups may be explained by the persistent iodine deficiency as well as by the frequent exposure to unknown amounts of iodine in patients with thyroid disease. Therefore, the spontaneous TcTU alone cannot identify a small group of patients with autonomy and high risk of iodine-induced hyperthyroidism, from a very large group of patients with goitre.