Oral iodized oil is the major alternative to iodized salt for correcting endemic iodine deficiency. This study responds to a need for better guidelines in its use. Schoolchildren, aged 6-11 yr, from a severely iodine-deficient area of Algeria received iodized poppy seed oil (Lipiodol) in a single oral dose containing 120, 240, 480, or 960 mg iodine (groups A-D) or in an im injection of 480 mg iodine (group E). Thyroid volume by ultrasonography had not changed 395 days after treatment in groups A, B, and C, had decreased in groups D and E. Urinary iodine concentration rose rapidly from an initial median of 0.21 mumol/L, but fell below 0.79 mumol/L (the currently accepted level for indicating iodine deficiency) by 150 days for groups A and B, and by 395 days for groups C and D. Median serum TSH and T4 levels were normal before and after treatment, whereas high initial serum thyroglobulin values decreased in all groups after iodized oil treatment. For correcting iodine deficiency in children, we recommend single oral doses of Lipiodol containing 240 mg iodine for 6-month coverage or 480 mg for 12 months. These doses may not completely sustain iodine sufficiency, but will prevent the worst of the iodine deficiency disorders. Additionally, we conclude that the urinary iodine concentration is the most useful epidemiological indicator for assessing current iodine status, and thyroid volume and serum thyroglobulin levels are the best markers for assessing chronic effects.

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ABSTRACT:Background: There is debate on the neurological impact of chronic exposure to Manganese (MN). Methods: MN burden from rural well water was studied cross-sectionally in two proband cohorts from rural dwellings located in northern Germany. Both cohorts had exposure times for up to 40 years and were separated on the basis of well water MN content. Group A (41 subjects; mean age 57.5 years) was exposed to MN water contents of at least 0.300 mg/1 (range 0.300 to 2.160), while group B (74 subjects; mean age 56.9 years) was exposed to concentrations of less than 0.050 mg/1. Both proband groups were homogenous with regard to age, sex, nutritional habits, and drug intake. Neurological assessments by clinical investigators blinded for proband's exposure status was done using structured questionnaires, standardized neurological examination with assessment of possible Parkinsonian signs by the Columbia University Rating Scale, and instrumental tests of fine motor coordination. Results: No significant difference in any neurological measure was found between groups. Results were not confounded by demographic and dietary features. Conclusion: Exposure to high body burden of MN does not result in detectable neurological impairment. Exposure to MN in drinking water does not seem to be a risk factor for idiopathic Parkinson's disease. RESUME: L'exposition a long terme au manganese dans l'eau de puits n'a pas de repercussion neurologique. Introduction: Les repercussions neurologiques d'une exposition chronique au manganese (MN) demeurent une source de controverse. Methodes: Nous avons effectue une 6tude transversale de la charge en MN chez deux cohortes de sujets habitant la campagne dans le nord de l'Allemagne. Chez les individus des deux cohortes, le temps d'exposition pouvait atteindre 40 ans. Le groupe A (41 sujets; 57.5 ans d'Sge moyen) avait 6t6 exposd a de l'eau dont la teneur en MN etait d'au moins 0.300 mg/1 (intervalle de 0.300 a 2.160), alors que le groupe B (74 sujets; 56.9 ans d'age moyen) avait 6t6 expose a des concentrations de moins de 0.050 mg/1. Les deux groupes de sujets fitaient homogenes quant a l'age, au sexe, aux habitudes alimentaires et a la prise de medicaments. Des investigateurs cliniques ignorant le niveau d'exposition des sujets ont effectue une evaluation neurologique au moyen d'un questionnaire structure, d'un examen neurologique standardise avec evaluation des signes parkinsonians au moyen de l'echelle de l'universite Columbia lorsque pertinent, ainsi que des 6preuves de motricite' fine. Resultats: Nous n'avons pas observe de difference significative pour quelque mesure que ce soit entre les deux groupes. Les resultat n'etaient pas influences par des particularites dfimographiques ou alimentaires. Conclusions: L'exposition a une charge corporelle elevee en MN ne provoque pas de deficit neurologique d6celable. L'exposition au MN dans l'eau potable ne semble pas etre un facteur de risque de la maladie de Parkinson.

The results of this trial suggest that the suppression of endogenous gonadotrophins by conventional doses of an LHRH agonist produces no relevant beneficial effects in patients with advanced ovarian carcinoma who receive standard surgical cytoreduction and cytotoxic chemotherapy.

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