INCAP Studies of Endemic Goiter and its Prevention

Scrimshaw, Nevin S.

doi:10.1177/156482651003100111

Cited by 7 publications

(9 citation statements)

References 11 publications

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“…For example, as early as the 1950s, researchers in Guatemala were concerned with the epidemiology of endemic goitre, which at that time affected more than 50% of the rural adult population 33. Indeed, Guatemala was one of the first countries in Latin America—and the first in Central America—to pass legislation requiring iodisation of table salt 34.…”

Section: Global Health Problem Analysismentioning

confidence: 99%

Myxoedema in a patient with achondroplasia in rural area of Guatemala

Juarez

Rohloff²

2017

BMJ Case Reports

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A 43-year-old indigenous Guatemalan woman with achondroplasia presented to our clinic with chronic fatigue and generalised oedema. She had limited contact with the formal healthcare system. However, 1 year prior, she had sought medical evaluation from a private physician. Her symptoms had been attributed to a combination of heart failure and physical disability due to the musculoskeletal complications of her achondroplasia. She was lost to follow-up due to inability to pay for further testing or treatment. On initial laboratory evaluation in our clinic, she was found to have a thyrotropin level greater than assay. With initiation of oral levothyroxine supplementation, her dyspnoea and oedema completely resolved. The case illustrates how indigenous patients in rural Guatemala experience many barriers to accessing high-quality medical care. As a result, presentations of common illnesses are often very advanced and definitive diagnoses and treatments are frequently delayed.

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Section: Global Health Problem Analysismentioning

confidence: 99%

Myxoedema in a patient with achondroplasia in rural area of Guatemala

Juarez

Rohloff²

2017

BMJ Case Reports

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“…Eye lesions attributable to vitamin A deficiency were rare, despite evidence of deficiency revealed by biochemical studies. These three nutrients are discussed in detail in other articles in this issue [5,10,11].…”

Section: Clinical Studiesmentioning

confidence: 99%

Investigation of the Nutrition Problems of Central America and Panama

Arroyave¹,

Scrimshaw²

2010

Food Nutr Bull

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“…The history of epidemiology contains several examples of cluster investigations that led to landmark discoveries of disease etiology. Those include recognition of new infectious agents (Fraser etal., 1977; CDC, 2006), connections between nutritional deficiencies and human illness (Elmore & Feinstein, 1994; Scrimshaw, 2010), and identification of previously unknown carcinogens (Doll, 1975; Bosetti et al, 2003). …”

Section: Introductionmentioning

confidence: 99%

Cancer clusters in the USA: What do the last twenty years of state and federal investigations tell us?

Goodman¹,

Naiman²,

Goodman³

et al. 2012

Critical Reviews in Toxicology

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BackgroundCancer clusters garner considerable public and legislative attention, and there is often an expectation that cluster investigations in a community will reveal a causal link to an environmental exposure. At a 1989 national conference on disease clusters, it was reported that cluster studies conducted in the 1970s and 1980s rarely, if ever, produced important findings. We seek to answer the question: Have cancer cluster investigations conducted by US health agencies in the past 20 years improved our understanding of cancer etiology, or informed cancer prevention and control?MethodsWe reviewed publicly available cancer cluster investigation reports since 1990, obtained from literature searches and by canvassing all 50 states and the District of Columbia. Investigations were categorized with respect to cancer type(s), hypothesized exposure, whether perceived clusters were confirmed (e.g. by elevated incidence), and conclusions about a link between cancer(s) of concern and hypothesized environmental exposure(s).ResultsWe reviewed 428 investigations evaluating 567 cancers of concern. An increase in incidence was confirmed for 72 (13%) cancer categories (including the category “all sites”). Three of those were linked (with variable degree of certainty) to hypothesized exposures, but only one investigation revealed a clear cause.ConclusionsIt is fair to state that extensive efforts to find causes of community cancer clusters have not been successful. There are fundamental shortcomings to our current methods of investigating community cancer clusters. We recommend a multidisciplinary national dialogue on creative, innovative approaches to understanding when and why cancer and other chronic diseases cluster in space and time.

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INCAP Studies of Endemic Goiter and its Prevention

Abstract: Abstract

Cited by 7 publications

References 11 publications

Myxoedema in a patient with achondroplasia in rural area of Guatemala

Myxoedema in a patient with achondroplasia in rural area of Guatemala

Investigation of the Nutrition Problems of Central America and Panama

Cancer clusters in the USA: What do the last twenty years of state and federal investigations tell us?

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