Clinical and forensic aspects of potassium iodide: Suddenly in high demand across Europe due to fears of radiation poisoning from a nuclear attack in Ukraine

Potassium iodide has demonstrated several therapeutic applications over time, being the choice for shielding the thyroid during radiation emergencies involving radioiodine release. Amidst the ongoing military conflict between Ukraine and Russia and the growing concern regarding the potential deployment of nuclear weapons, there has been a surge in the demand for potassium iodide across Europe. This work aimed to comprehensively review the current knowledge regarding the pharmacology, physiology, adverse effects, the protective role in reducing the risk of thyroid cancer and recommendations for potassium iodide use during radiation emergencies. Evidence on adverse effects is scarce, as potassium iodide is generally well-tolerated. Guidelines for thyroid blocking with potassium iodide during radiation emergencies suggest that, among populations vulnerable to radioiodine exposure, the benefits of potassium iodide outweigh the risks of adverse effects. Controversial topics surrounding the utilization of potassium iodide in radiation emergencies include the prophylaxis in iodine-deficient regions and following the detonation of dirty bombs, whether granule formulations versus tablets should be used and mental health concerns. Although the rise in demand seems to be a justified security measure, it is essential to recognize that potassium iodide protects the thyroid from radioiodine and does not impact the body's absorption of other radioactive materials or defend against external radiation exposure.

Iodine level of goats from Shiwalik and middle mountains of north-west Himalayas in relation to soil, fodder, and water status

A baseline survey was carried out to determine the iodine status of goats and its relationship with the levels of soil, water, and fodder samples collected from different agro-climatic zones (sub-tropical, lower, and upper-intermediate) of the Jammu division. A total of 74 blood and 60 milk samples from goats, as well as soil (50), water (50), and fodder (56) samples, were collected. Plasma inorganic iodine (PII), milk inorganic iodine (MII), iodide ion (I-), and thyroid hormone (T3 and T4) levels were measured along with biochemical parameters. The average PII, I-, and MII concentrations of goats from unorganized farms were 55.99±4.56 ng/ml, 1.37±0.11 ppm, and 47.3±5.68 ng/ml compared 74.68±8.40 ng/ml, 1.43±0.11 ppm and 62.01±8.55 ng/ml, respectively from the organized farm. Based on PII level, 71.62% of goats had moderate deficiency (level 50-100 ng/ml) and 28.37% had severe deficiency (level <50 ng/ml). The average levels of iodine in soil and water were 0.24 ppm and 0.06 ppm, respectively. Rabi and kharif fodders showed average iodine levels of 1.25 ppm and 0.37 ppm, respectively. Significant changes were recorded in glucose, HDL and T4 levels. Pearson correlation performed between PII (ng/ml) and biochemical parameters established correlation with T4 (r = -0.465), glucose (r = 0.510), HDL (r = -0.355) and cholesterol (r = 0.271). The study concluded that iodine deficiency is prevalent in the goat population due to lower levels in the environment implying an urgent need for regular supplementation in the diet.

HPLC Analysis of the Urinary Iodine Concentration in Pregnant Women

Iodine is an essential component for fetal neurodevelopment and maternal thyroid function. Urine iodine is the most widely used indicator of iodine status. In this study, a novel validated ion-pair HPLC-UV method was developed to measure iodine concentration in clinical samples. A sodium thiosulfate solution was added to the urine sample to convert the total free iodine to iodide. Chromatographic separation was achieved in a Pursuit XRs C8 column. The mobile phase consisted of acetonitrile and a water phase containing 18-crown-6-ether, octylamine and sodium dihydrogen phosphate. Validation parameters, such as accuracy, precision, limits of detection and quantification, linearity and stability, were determined. Urinary samples from pregnant women were used to complete the validation and confirm the method's applicability. In the studied population of 93 pregnant women, the median UIC was lower in the group without iodine supplementation (117 µg/L, confidence interval (%CI): 95; 138) than in the supplement group (133 µg/L, %CI: 109; 157). In conclusion, the newly established ion-pair HPLC-UV method was adequately precise, accurate and fulfilled validation the criteria for analyzing compounds in biological fluids. The method is less complicated and expensive than other frequently used assays and permits the identification of the iodine-deficient subjects.

Pregnant Women Are Iodine Deficient While School-Aged Children Demonstrate Adequate Iodine Status in Sarawak, Malaysia

BACKGROUND

A mandatory universal salt iodization (USI) has been implemented in Sarawak, Malaysia since 2008.

OBJECTIVES

The aim of this study is to assess the current iodine status among school-aged children (SAC) and pregnant women (PW) after 10 years of USI implementation in Sarawak.

METHODS

This cross-sectional survey among school-aged children and pregnant women was conducted between July and October 2018 in Sarawak. The multistage proportionate to population size sampling technique was used to select 30 schools and 30 maternal and child health care clinics. A total of 1200 children aged 8 to 10 years and 750 first-trimester pregnant women were randomly selected to participate in the study. Iodine excretion level in urine was determined according to the World Health Organization classification.

RESULTS

A total of 988 children and 677 PW participated in the study with a response rate of 82.3% and 90.2%, respectively. The overall median urinary iodine concentration (UIC) level among the children was 126.0 μg/L (interquartile range [IQR], 71.0-200.9 μg/L) and classified as adequate iodine status. The median UIC among PW was 123.9 μg/L (IQR, 56.5-192.1μg/L) indicating inadequate iodine status.

CONCLUSION

The present findings indicate that despite adequate iodine status in children, the majority of PW still showed inadequate iodine status. Thus, comprehensive monitoring of the iodine deficiency disorder problem among PW is warranted.

Speciation of Bio-Available Iodine in Abalone (Haliotis discus hannai) by High-Performance Liquid Chromatography Hyphenated with Inductively Coupled Plasma-Mass Spectrometry Using an In Vitro Method

Abalone is one of the most valuable marine products found in East Asia because it is rich in nutritious substances including iodine. In this study, the in vitro dialyzability approach was used to assess the bio-available iodine species in abalone. Iodide, iodate, 3-iodo-L-tyrosine (MIT), and 3,5-diiodo-L-tyrosine (DIT) were separated by high-performance liquid chromatography hyphenated with inductively coupled plasma-mass spectrometry (HPLC-ICP-MS). To assure the consistency, reliability, and accuracy of the data, the method was validated. Comparison of the total iodine in abalone muscle and viscera indicated that abalone muscle showed greater digestion/absorption efficiency than abalone viscera (digestion efficiency: 68.13 ± 2.59% and 47.88 ± 5.76% and absorption efficiency: 59.78 ± 2.93% and 35.12 ± 1.43% for abalone viscera and muscle, respectively). However, evaluation of the sum of the analyzed iodine species targeted in this study by HPLC-ICP-MS indicated that abalone muscle showed lower digestion efficiency and similar absorption efficiency compared to that of abalone viscera (digestion efficiency: 35.52 ± 5.41% and 28.84 ± 1.83%; absorption efficiency: 23.56 ± 4.38% and 27.56 ± 1.51% for abalone viscera and muscle, respectively). The main forms of iodine detected in abalone muscle were iodide and MIT, whereas iodide was the major form in abalone viscera.

PRACTICAL APPLICATION

The bio-available iodine in abalone was quantified via an in vitro method employing HPLC-ICP-MS. The results of this study indicated that abalone is feasible as a new iodine source and may prospectively find application in iodine-fortified foods.

Evaluation of iodine intake and status using inductively coupled plasma mass spectrometry in urban and rural areas in Benin, West Africa

OBJECTIVE

Iodine deficiency has severe pathological repercussions. The aim of this study was to evaluate iodine intake and status in adults in Benin, West Africa.

METHODS

We randomly selected 420 participants ages 25 to 64 y and free of visible goiter from urban and rural settings of South Benin. The participants had a diet based on carbohydrates and fish. Urine was collected over a 24-h period and samples were assayed for iodine analysis using inductively coupled plasma mass spectrometry.

RESULTS

We studied 401 urinary iodine samples. The overall median urinary iodine concentration (UIC) in 24-h urine was 62.9 μg/L (interquartile range: 40-96.2 μg/L). UIC was significantly lower in women than men (56.5 versus 78.6 μg/L; P < 0.001) and in rural versus urban areas (54.7 versus 77.8 μg/L; P < 0.001). In multivariate analysis, low UIC (<100 μg/L) was positively associated with women (odds ratio, 2.48; 95% confidence interval, 1.44-4.26; P = 0.001) and body mass index <25 kg/m(2) (odds ratio, 2.06; 95% confidence interval, 1.20-3.54; P = 0.008).

CONCLUSION

Iodine intake appeared to be fairly low in the Beninese population, according to World Health Organization criteria, and factors associated with low iodine intake were identified. Public health interventions to increase iodine intake, such as iodization of commercial salt and/or fortification of selected nutrients, should be strengthened at the national level.

Iodide sensing via electrochemical etching of ultrathin gold films

Iodide is an essential element for humans and animals and insufficient intake is still a major problem. Affordable and accurate methods are required to quantify iodide concentrations in biological and environmental fluids. A simple and low cost sensing device is presented which is based on iodide induced electrochemical etching of ultrathin gold films. The sensitivity of resistance measurements to film thickness changes is increased by using films with a thickness smaller than the electron mean free path. The underlying mechanism is demonstrated by simultaneous cyclic voltammetry experiments and resistance change measurements in a buffer solution. Iodide sensing is conducted in buffer solutions as well as in lake water with limits of detection in the range of 1 μM (127 μg L(-1)) and 2 μM (254 μg L(-1)), respectively. In addition, nanoholes embedded in the thin films are tested for suitability of optical iodide sensing based on localized surface plasmon resonance.

Coronary artery calcium score: a review

Context

Coronary artery disease (CAD) is the foremost cause of death in many countries and hence, its early diagnosis is usually concerned as a major healthcare priority. Coronary artery calcium scoring (CACS) using either electron beam computed tomography (EBCT) or multislice computed tomography (MSCT) has been applied for more than 20 years to provide an early CAD diagnosis in clinical routine practice. Moreover, its association with other body organs has been a matter of vast research.

Evidence Acquisition

In this review article, techniques of CACS using EBCT and MSCT scanners as well as clinical and research indications of CACS are searched from PubMed, ISI Web of Science, Google Scholar and Scopus databases in a time period between late 1970s through July 2013 and following appropriate selection, dealt with. Moreover, the previous and ongoing research subjects and their results are discussed.

Results

The CACS is vastly applied in early detection of CAD and in many other research fields.

Conclusions

CACS has remarkably changed the screening techniques to detect CAD earlier than before and is generally accepted as a standard of reference for determination of risk of further cardiac events.

Distribution of breast density in Iranian women and its association with breast cancer risk factors

Background:

Breast cancer is one of the most common cancers and the first-leading cause of cancer deaths among women in the world. Indeed, breast cancer is ranked as the first malignancy among Iranian women. Breast density, defined as the percentage of fibro glandular breast tissue in mammographic images, is one of the known risk factors for breast cancer. According to American college of radiology-Breast Imaging Reporting and Data System (ACR-BIRADS), mammographic density is divided into four categories. Studies have shown that increased breast density is associated with significant increase in breast cancer risk. Therefore, it is assumed that breast density should be associated with other breast cancer risk factors.

Objectives:

The aim of this study was to assess the epidemiologic distribution of breast density of the patients in a referral center in Iran, and to evaluate the association of high breast density and breast cancer risk factors and other factors that may possibly affect the mammographic density according to previous studies.

Patients and Methods:

In an analytical cross-sectional study, 728 of those who had referred to Imam Khomeini Imaging Center either for diagnostic or screening purposes, participated in the study, after filling out the informed consent form, the survey questionnaire based survey assessing breast cancer risk factors affecting the breast density and related demographic features, was conducted. SPSS 11.5 software and chi-square, t-test and logistic regression tests were used to analyze the data.

Results:

Most of patients (75%) in categories 2 and 3 of mammographic density had a breast density of 51.9%, however, this amount was less (49.2%) in screening mammograms, while in diagnosing group it was more (51.6%). The Findings showed an increase in age, body mass index (BMI), duration of breast feeding, and also to be menopause e, unemployed and married, younger than 29 years old at first delivery, having children up to 8 and smoking are associated with less breast density. Diagnostic mammograms and symptomatic patients showed denser breasts. But density had no association with oral contraceptives pill (OCP) consumption or hormone replacement therapy or calcium and/or vitamin D consumption, age at menarche and menopause, menstruation cycle phase and family history of breast cancer. Age at the first delivery, menopausal status and parity were independently associated with breast density.

Conclusions:

Density distribution and risk factors prevalence is different among symptomatic patients and the diagnostic mammograms of the screened persons, hence such information should be considered in the patient managements. In order to consider the effect of marriage and parity on decreasing the breast density, basic consultations should be performed. Smokers and obese women may falsely show low breast density while they may be in high-risk group. In this study no specific phase of menstrual cycle is suggested for mammographic examinations.