Background: Iodine is the key element for thyroid hormone synthesis, and its deficiency, even moderate, is harmful in pregnancy, when needs are increased, because of its potential deleterious effects on fetal brain development. In Portugal, no recent data on iodine intake exists. The objective of this countrywide study was to analyze iodine status in pregnant Portuguese women in order to propose adequate measures to the health authorities. Subjects and methods: Using a fast colorimetric method, urine iodine concentration (UIC) was evaluated in 3631 pregnant women followed in 17 maternity hospitals from hinterland and coastal areas in Continental Portugal and the Portuguese islands of Açores and Madeira. Results: Median UIC value was 84.9 mg/l (range 67.6-124.1) in Continental Portugal, 69.5 mg/l in Madeira, and 50.0 mg/l in Açores. The percentage of satisfactory values (O150 mg/l) was 16.8, ranging from 8.8 to 34.1 in the Continent, and being 8.2 in Madeira and 2.3 in Açores. The percentage of values below 50 mg/l was 23.7, ranging from 14.0 to 37.4 in the Continent, 33.7 in Madeira, and 50.0 in Açores. Conclusions: Our results point to an inadequate iodine intake in pregnant women assisted in most Portuguese maternity hospitals. Considering the potential deleterious effects of inadequate iodine supply in pregnancy, iodine supplementation is strongly recommended in this period of life.

Present results suggest that the interference on Tg measurement observed in the presence of TgAb may result not only from the anti-thyroglobulin antibodies, but also from the thyroglobulin itself.

Background: High levels of vascular endothelial growth factor (VEGF) have been reported in patients with cancers of different origins. There are no data comparing serum VEGF levels of medullary thyroid carcinoma (MTC) patients with that of the healthy subjects. Objective: We tried to assess whether serum VEGF concentration in MTC patients is correlated with tumour extension and whether this marker might be used to further refine the selection of candidates for future therapies with receptor tyrosine kinase inhibitors. Methods: Sera from 57 individuals divided into five groups: group I, healthy individuals (nZ14); group II, MTC patients in remission (nZ10); group III, MTC patients with residual disease (nZ12); group IV, MTC patients with loco-regional disease (nZ11) and group V, MTC patients with distant metastases (nZ10) were analysed for serum VEGF and calcitonin (CT) levels. Results: Analysis of serum VEGF did not disclose significant differences among the five groups. Mean serum VEGF level of patients with distant metastases was not significantly different from that observed in healthy individuals (319.4G49.78 vs 313.7G43.13 ng/l). Serum VEGF levels correlated positively with serum CT (rZ0.4891; PZ0.0394) for CT values below 2500 ng/l whereas there was no correlation for CT values above this threshold. Conclusions: Serum VEGF levels in MTC patients are not significantly different from those found in healthy individuals and did not correlate with the extension of disease.

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The analysis of serum thyroglobulin (Tg) following thyroid-stimulating hormone (TSH) stimulation (sTg) has been recommended in the follow-up of differentiated thyroid carcinoma (DTC) patients, however, its routine use remains controversial. The aim of the current study was to evaluate the accuracy of sTg testing following recombinant human (rh) TSH stimulation in DTC patients, with a follow-up of 12.4 years. Retrospective studies were conducted of 125 DTC patients, who underwent rhTSH stimulation testing between 1999 and 2002. The exclusion criteria were: Patients with anti-Tg antibodies, Tg levels >1 ng/ml under TSH suppression and the absence of radioactive iodine (RAI) ablation therapy following surgery. In total, 49 patients were included in the study and all had been previously treated with total or near total thyroidectomy (with or without central neck dissection) and RAI, postoperatively. The Tg functional sensitivity was 1.0 ng/ml. The follow-up for patients was performed annually. During the median follow-up of 12.4 years after the rhTSH stimulation test, nine patients exhibited recurrence (18.4%). Of the nine patients, six exhibited sTg levels >2 ng/ml (positive result) and three exhibited levels <2 ng/ml (negative result). Relapse occurred at a mean of 5.9 years following the rhTSH stimulation test. The positive predictive value and negative predictive value (NPV) of positive sTg were 50 and 91.9%, respectively, with a sensitivity of 66.6% and a specificity of 85.0%. The rhTSH-stimulated Tg levels have a high NPV, allowing the identification of the patients who are free of the tumour. These results are consistent with the previously published data; however, to the best of our knowledge, this is the study with the longest follow-up duration after rhTSH stimulation.

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