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F Aghini-Lombardi

Publications and source records attributed to F Aghini-Lombardi.

At least 19 recordsLinked to original sources
PubMed1999

The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano survey.

We carefully assessed thyroid status and goiter by ultrasound in 1411 subjects virtually representing the entire resident population of Pescopagano, an iodine-deficient village of Southern Italy. Median urinary iodine excretion was 55 microg/L. The prevalence of goiter was 16.0% in children and 59.8% in adults. Thyroid nodularity was 0.5% in children and progressively increased with age to 28.5% in the 56- to 65-yr-old group. The prevalence of present or past hyperthyroidism was 2.9%, including 9 cases with toxic diffuse goiter and 20 with toxic nodular goiter. Functional autonomy was rare in children, progressively increased with age up to 15.4% in the elderly, and was related to nodular goiter. The prevalences of overt and subclinical hypothyroidism in the adults were 0.2% and 3.8%, respectively. Serum autoantibodies to thyroglobulin and thyroperoxidase were detected in 12.6% of the entire population. The prevalence of diffuse autoimmune thyroiditis was 3.5%, being very low in children. Thyroid cancer was found in only 1 case. In conclusion, in the present survey of an iodine-deficient community, a progressive increase with age of goiter prevalence, thyroid nodularity, and functional autonomy was observed. Hyperthyroidism was twice as high as that reported in iodine-sufficient areas, mainly due to an increased frequency of toxic nodular goiter. Although low titer serum thyroid antibodies were relatively frequent, the prevalences of both overt and subclinical autoimmune hypothyroidism were not different from those observed in iodine-sufficient areas.

Adolescent↗
PubMed1998

[Epidemiology of endemic goiter in Italy].

Epidemiological surveys on goiter endemia carried out in Italy in the two last decades were recently reviewed. Iodine deficiency and endemic goiter were documented in the entire country. In recent studies, urinary iodine excretion was higher and prevalence of goiter was lower than that documented in the past, in absence of a national program of prophylaxis. Nevertheless, in a recent study carried out in Basilicata, in schoolchildren a goiter prevalence of 16% was documented. In conclusion, iodine deficiency and endemic goiter are still present in Italy; despite the beneficial effects of "silent prophylaxis", a iodine prophylaxis program is mandatory.

Adolescent↗
PubMed1998

[Efficacy and safety of iodine prophylaxis].

Iodine deficiency and iodine deficiency disorders (IDD) are still present in developing countries as well as in some European areas. It is well known that iodine deficiency correction prevents endemic goiter and other IDD. Iodized oil has been shown to reduce goiter prevalence and cretinism in African countries. In countries where iodine prophylaxis is performed since many years (USA, Switzerland, Scandinavian countries) IDD are dramatically reduced. One example of the efficacy of iodine prophylaxis through iodized salt was reported in a Tuscan village were urinary iodine excretion increased from 47 micrograms/l in 1981 to 130 micrograms/l in 1991. Goiter prevalence in schoolchildren dropped from 60% in 1981 to 8.1% in 1991. In the same children neuropsychological performances were evaluated showing a reduction of motor response to perceptive stimuli assessed by measurement of reaction times in children born before the beginning of iodine prophylaxis. Iodine prophylaxis has no side effects, although a transitory increase of hyperthyroidism has been reported in the past and recently in African countries. A reevaluation by the experts of the International Council for the Control of Iodine Deficiency Disorders (ICCIDD) has pointed out that this phenomenon is not relevant with respect to the efficacy of iodine prophylaxis. In conclusion, universal iodine prophylaxis prevents endemic goiter and other IDD, without side effects.

Child↗
PubMed1998

[Iodine prophylaxis legislation in Italy].

Italian laws allow production and selling of iodized salt but this is still consumed on a voluntary basis. Thus, the use of iodized salt amounts to 3% of the used salt. Selling iodized salt instead of common salt would be the most effective iodine prophylaxis method. The Consiglio Superiore di Sanità has recently voted a document which asks the authorities to make the selling of iodized salt compulsory. Selling common salt to the people who explicitly ask for it could be a good alternative to the compulsory prophylaxis. The food education campaign promoted by the Italian Ministry of Health could provide an important contribution for the success of the iodine prophylaxis.

Deficiency Diseases↗
PubMed1998

[Epidemiology of endemic goiter in Tuscany].

In the present study, the data of epidemiological surveys carried out in Tuscany from 1981 to 1993 in schoolchildren population (6-14 years) residing in extraurban hilly and mountain areas are reported. Mild iodine deficiency and high prevalence of goiter were documented in the epidemiological surveys carried out up to 1990. An increase in urinary iodine excretion with a dramatic decrease in goiter prevalence was documented in the more recent surveys, independently from iodine prophylaxis. The results observed in Garfagnana and in Val Tiberina after the implementation of iodized salt confirmed the necessity to promote prophylaxis programs extended to the entire population.

Adolescent↗
PubMed1998

[Effects of iodine prophylaxis on a voluntary basis on the thyroid volume of a young population in Val Tiberina].

In the present study, the thyroid volume of children residing in an area (Val Tiberina in Tuscany) characterized by moderate iodine deficiency in the past, was evaluated after iodized salt prophylaxis. In children born before the institution of iodine prophylaxis, thyroid volume was significantly higher than that in controls, both considering the entire population and only the nongoitrous children. In children born after iodine prophylaxis, no difference in thyroid volume was found with respect to controls. The data of the present study indicate that the exposure to iodine deficiency causes an enlargement of thyroid volume in schoolchildren. The iodized salt prophylaxis is able to prevent the development of goiter in the children born after prophylaxis and to keep the further increase of thyroid volume in older children.

Adolescent↗
PubMed1997

Effect of iodized salt on thyroid volume of children living in an area previously characterized by moderate iodine deficiency.

It is well established that an adequate iodine intake prevents iodine deficiency disorders. Prophylaxis through iodized salt is able to correct urinary iodine deficiency and to prevent goiter endemia, but scanty data are available about its effect on decreasing the thyroid size in goitrous children born before prophylaxis. The prevalence of goiter was evaluated by ultrasound in the school-children population of an area of Eastern Tuscany (Tiberina Valley) characterized by moderate iodine deficiency in 1985. At present, after the implementation of voluntary iodized salt consumption, iodine urinary excretion was borderline sufficient (median, 98 micrograms/L). Goiter prevalence was higher at ultrasound (17%) than by palpation (10%). The median thyroid volume ranged from 3.1 mL in 7-yr-old children to 9.2 mL in 14-yr-old children. In the 7-10 yr age class (i.e. in children born after iodine prophylaxis), no statistical difference in thyroid volume was found with respect to controls. In older children (11-14 yr) born before the institution of iodine prophylaxis, the median thyroid volume was significantly higher than that in age-matched controls. Moreover, in this cluster of subjects, the median thyroid volume in nongoitrous children was higher than that in controls. In conclusion, the data of the present study indicate that the iodized salt prophylaxis is able to prevent the development of goiter in children born after the implementation of iodized salt consumption and to further control thyroid enlargement in older children, but is less effective (or rapid) in reducing goiter size in children exposed to iodine deficiency in the first years of life.

Adolescent↗
PubMed1994

Serum interleukin-6 in amiodarone-induced thyrotoxicosis.

Amiodarone, an iodine-rich cardiac drug, may induce thyrotoxicosis (AIT), which can occur in patients with preexisting thyroid abnormalities and in subjects with apparently normal thyroid glands. The pathogenesis of AIT is often due to iodine-induced excessive thyroid hormone synthesis, especially in patients with underlying thyroid disease. In some instances, however, AIT may be related to a destructive process due to amiodarone-induced thyroiditis, resulting in thyroid cell damage and thyroid hormone release into the circulation. Another thyroid inflammatory process, subacute thyroiditis, has been recently reported to be associated with markedly increased serum interleukin-6 (IL-6) levels. To investigate the significance of serum IL-6 levels in AIT, we evaluated in a cross-sectional study the following subjects: 27 AIT patients, 15 with no apparent thyroid abnormalities (AIT-) and 12 with nodular goiter and/or thyroid autoimmune disease (AIT+); 14 euthyroid patients receiving chronic amiodarone therapy; 10 patients with amiodarone-induced hypothyroidism; 56 patients with spontaneous hyperthyroidism due to Graves' disease (n = 35) or toxic adenoma/nodular goiter (n = 21); 20 subjects with nontoxic goiter; and 50 healthy controls. Serum free thyroid hormone concentrations did not differ in patients with amiodarone-induced or spontaneous hyperthyroidism. Mean (+/- SE) serum IL-6 values were as follows: AIT-, 573.5 +/- 78.7 fmol/L (range, 149.4-1145.1); AIT+, 152.7 +/- 46.3 fmol/L (range, < 25-505.6); euthyroid patients receiving chronic amiodarone therapy, 51.4 +/- 10.0 fmol/L (range, < 25-122.5); amiodarone-induced hypothyroidism, 43.8 +/- 8.4 fmol/L (range, < 25-84.3); Graves' disease, 108.2 +/- 18.2 fmol/L (range, < 25-250); toxic adenoma/nodular goiter, 97.6 +/- 10.3 fmol/L (range, < 25-168.9); nontoxic goiter, 47.3 +/- 7.1 fmol/L (range, < 25-106.6); and controls, 37.8 +/- 6.2 fmol/L (range, < 25-99.4). Serum IL-6 values in AIT- patients were markedly higher (P < 0.0001) than those in all other groups. Values in AIT+, although slightly higher, did not significantly differ from those in patients with spontaneous hyperthyroidism. AIT- patients had low 24-h thyroidal radioiodine uptake (RAIU), whereas AIT+ had inappropriately low normal to high (9-58%) RAIU values in the presence of excess iodine. The presence of markedly elevated serum IL-6 concentrations and low thyroidal RAIU values in patients with AIT without underlying thyroid disease suggests the presence of amiodarone-induced thyroiditis as the etiology of thyrotoxicosis. Treatment of 2 such patients with prednisone was associated with a dramatic reduction and prompt normalization of IL-6 and thyroid hormone values.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1994

Thyroid volume measurement by ultrasound in children as a tool for the assessment of mild iodine deficiency.

Thyroid ultrasound was used to measure thyroid volume in children and compared with thyroid palpation for the assessment of the prevalence of goiter in an area of mild iodine deficiency. School children, 6-14 yr old, were from control areas (n = 2693; urinary iodine excretion, 110 micrograms/L) or from an area of mild iodine deficiency (IDA; n = 278; urinary iodine excretion, 72 micrograms/L). Thyroid volume determined by ultrasound in control children increased with age (r = 0.62; P < 0.0001) and was significantly correlated with height (r = 0.51; P < 0.0001) and body weight (r = 0.126; P < 0.0001). Both median and mean thyroid volumes were greater in IDA children than in controls. The prevalence of goiter determined by ultrasound was 68 of 268 children (25.3%) in IDA and 105 of 2693 children (3.9%) in the control area (chi 2 = 204; P < 0.0001). Thyroid enlargement, as assessed by palpation, was found in 59 of 268 children (22%) in the IDA group and in 165 of 2693 (6.1%) subjects in the control area (chi 2 = 88; P < 0.0001). Some subjects of the IDA who were judged goitrous by palpation (11.2%) had a normal thyroid volume at ultrasound, and 12.7% of subjects with an abnormal thyroid volume at ultrasound were judged nongoitrous by palpation. In conclusion, 1) thyroid volume in children, as assessed by ultrasound, increases with age and is closely related to the parameters of body growth; 2) in every age group, thyroid ultrasound shows greater thyroid volume in an IDA group than in controls; and 3) a discrepancy between palpation and ultrasound is found in 23.9% of children living in an IDA, confirming that palpation is relatively inaccurate for assessing the prevalence of goiter in mild iodine deficiency. These data indicate that thyroid volume measurement by ultrasound in children provides a useful tool for the assessment of goiter in mild iodine deficiency.

Adolescent↗
PubMed1994

[Transient neonatal hypothyroidism and iodine deficiency].

Iodine is the essential constituent of thyroid hormones. Iodine deficiency disorders, ranging from endemic goiter to cretinism, result from low dietary intake of iodine. The fetus and the newborn are more sensitive than adults to a reduced environmental iodine supply, and in iodine-deficient areas, transient neonatal hypothyroidism is frequently observed. This transient thyroid failure may be associated with neonatal goiter. Border-line elevated neonatal TSH levels frequently occur in iodine deficient areas, and result in a higher recalling rate in the screening for congenital hypothyroidism. Iodine prophylaxis is highly effective in preventing the development of iodine deficiency disorders including transient neonatal hypothyroidism. Since iodine prophylaxis in Italy is inadequate, variable degrees of iodine deficiency are still present all-over the Country, and are responsible of a higher incidence of transient neonatal hypothyroidism or hyperthyrotropinemia. Educational programs for the general population, health professionals, and decision makers are essential for a successful iodine prophylaxis. Elimination of iodine deficiency by the year 2000 has been recently pledged by WHO/UNICEF. This goal is feasible if pursued with sufficient vigor and resources.

Congenital Hypothyroidism↗
PubMed1993

Treatment of amiodarone iodine-induced thyrotoxicosis with plasmapheresis and methimazole.

The present report illustrates the clinical and biochemical outcome in two amiodarone iodine-induced thyrotoxicosis (AIIT) patients submitted to plasmapheresis. Amiodarone was discontinued, and treatment with MMI (40 mg/day) was started. In addition, patients were submitted to two sessions of plasma-exchange, with a one-day interval between the two session. In both patients serum total T3 (TT3) and free T3 (FT3) concentrations decreased promptly but in contrast to the serum TT3, FT3 levels remained steadily above the normal range. A similar behaviour was observed for total T4 and free T4 plasma concentrations. Interestingly, a clearcut clinical amelioration was observed in both patients even before a reduction of circulating free thyroid hormone concentrations could be documented. In conclusion, our experience indicates that plasmapheresis may be useful in order to obtain a rapid amelioration of severe clinical picture of thyrotoxicosis, but cannot be considered as a definite therapy in AIIT. It should be considered that plasmapheresis is not devoid of risks and is also a very expensive procedure.

Aged↗
PubMed1993

Iodized salt prophylaxis of endemic goiter: an experience in Toscana (Italy).

It is well established that iodine supplementation is effective in correcting iodine deficiency and reducing goiter prevalence. In Italy, legislation has allowed the production of iodized salt since 1972, but its consumption is on a voluntary basis. In the present study, the efficacy of legislative measures that made compulsory the availability of iodized salt in foodstores has been evaluated. Urinary iodine excretion and thyroid size, scored according to Pan American Health Organization recommendations, were determined prior to (1981) and 10 years after (1991) the introduction of legislative measures in the whole schoolchildren population residing in a restricted area of the Tuscan Appennines. Moreover, in 1991, thyroid volume was determined by ultrasonography. In 1981, mean urinary iodine excretion was 47.1 +/- 22.4 mg/kg creatinine (0.412 mumol/l) and goiter prevalence was 60%, indicating a moderate iodine deficiency. Eighty of the families subsequently used iodized salt on a regular basis; as a result of this excellent compliance, in 1991 the mean urinary iodine excretion increased to 129.7 +/- 73 mg/kg creatinine (1.24 mumol/l) and goiter prevalence dropped to 8.1%. The results of this study underline the effectiveness of iodine prophylaxis in correcting iodine deficiency and abating endemic goiter in schoolchildren, and suggest that implementation of measures that make compulsory the availability of iodized salt in foodstores overcomes the fact that there is no law governing the exclusive production and trading of iodized salt.

Adolescent↗
PubMed1990

Neuropsychological assessment in schoolchildren from an area of moderate iodine deficiency.

Neuropsychological assessment was carried out in schoolchildren from a montane area of Eastern Tuscany (Tiberina Valley). This area was found to be moderately iodine deficient (mean urinary iodine excretion: 39 micrograms/g creatinine), with a cumulative goiter prevalence of 51.9% in schoolchildren aged 6-14 yr (goiter prevalence in the control iodine-sufficient area: 5.6%). No significant differences in serum TT4, TT3, FT4I, TSH levels between the endemic and control areas were found, whereas serum thyroglobulin values were significantly higher in the iodine-deficient area (61 +/- 8 vs 17 +/- 1 ng/ml, p less than 0.01). No differences were found as to the height, body weight and pubertal development in the two areas. Neuropsychological assessment, performed in a representative sample of 50 schoolchildren from the endemic area and 50 schoolchildren from the control area, matched for age, sex and socioeconomical conditions, failed to show major differences between the two groups in the global neuropsychological performance and cognitive levels. However, minor but significant differences were noted in the information vocabulary and coding subtests, at least in children aged 8. Although familial cultural influences might play a role, it would appear that some marginal impairment, with particular regard to motor-perceptual functions, be present in areas of moderate iodine deficiency.

Adolescent↗
PubMed1988

Absence of serum thyroid hormone autoantibodies in patients chronically treated with amiodarone.

The role of iodine in the pathogenesis of thyroid hormone autoantibodies (THAA) was evaluated in a large series (n = 223) of patients submitted to chronic treatment (3-36 months) with the iodine-rich drug, amiodarone. Positive anti-T3 autoantibody (AbT3) tests were found only in one patient, whereas tests for anti-T4 autoantibody (AbT4) were negative in all cases. Likewise, the incidence of THAA in the control groups of patients with spontaneous thyroid disorders was low. The overall prevalence of THAA in the present series of 803 patients was 1.2% for AbT3 and 0.1% for AbT4. The present data strongly suggest that iodine plays a minor role, if any, in the occurrence of THAA.

Amiodarone↗
PubMed1988

Radioactive iodine thyroid uptake in patients with amiodarone-iodine-induced thyroid dysfunction.

Amiodarone, an iodine-rich drug, represents at the present, at least in Europe, one of the most common sources of iodine-induced thyroid dysfunction. The drug may induce both hypothyroidism and thyrotoxicosis. In spite of the large iodine intake occurring during amiodarone therapy, 131I thyroid uptake is detectable in patients with amiodarone-iodine-induced hypothyroidism, irrespective of the presence or absence of underlying thyroid disease. In contrast, in patients with amiodarone-iodine-induced thyrotoxicosis, 131I thyroid uptake is normal or even elevated in those with co-existent underlying thyroid disorders, whereas it is very low in those with an apparently normal thyroid gland. Perchlorate discharge test was performed in 8 patients with hypothyroidism and in 5 patients with hyperthyroidism induced by amiodarone: a positive test was found in all hypothyroid patients and a negative test in all hyperthyroid patients.

Adult↗