Fatima Borges

Iodine intake in Portuguese pregnant women: results of a countrywide study

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 μg/l (range 67.6-124.1) in Continental Portugal, 69.5 μg/l in Madeira, and 50.0 μg/l in Açores. The percentage of satisfactory values (>150 μg/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 μg/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.

Temporal behaviour of toroidal rotation velocity in the TCABR tokamak

A new method for determining the temporal evolution of plasma rotation is reported in this work. The method is based upon the detection of two different portions of the spectral profile of a plasma impurity line, using a monochromator with two photomultipliers installed at the exit slits. The plasma rotation velocity is determined by the ratio of the two detected signals. The measured toroidal rotation velocities of C III (4647.4 A) and C VI (5290.6 A), at different radial positions in TCABR discharges, show good agreement, within experimental uncertainty, with previous results (Severo et al 2003 Nucl. Fusion 43 1047). In particular, they confirm that the plasma core rotates in the direction opposite to the plasma current, while near the plasma edge (r/a > 0.9) the rotation is in the same direction. This technique was also used to investigate the dependence of toroidal rotation on the poloidal position of gas puffing. The results show that there is no dependence for the plasma core, while for plasma edge (r/a > 0.9) some dependence is observed.

Thyroid storm and arrhythmic storm: a potentially fatal combination.

Thyroid storm is a rare clinical emergency with a mortality rate between 20% and 30%. Cardiac arrhythmias associated with thyrotoxicosis are usually supraventricular. Ventricular arrhythmias are rarely associated with this entity and tend to occur in patients with intrinsic cardiac disease. We present a 35-year-old woman with Graves disease and a thyroid storm manifested with multiple malignant dysrhythmic episodes, without underlying cardiac disease. The mechanism for ventricular arrhythmia is not clear but seems to be due to the increased myocardial excitability directly caused by the thyroid hormones. The presence of myocarditis lesions may constitute an arrhythmogenic substratum and contribute further to this manifestation. This case emphasizes the importance of cardiac monitoring in patients with thyroid storm.

Multipoint Thomson Scattering Diagnostic For The TCABR Tokamak With Centimeter Spatial Resolution

This paper describes a multi‐point Thomson scattering system that is being developed for the TCABR tokamak based on a signal delay technique, which allows the determination of the electron temperature and plasma density radial profiles, with approximately 1 cm spatial resolution, employing just one spectrometer.

Encuesta sobre el tratamiento del carcinoma diferenciado de tiroides

INTRODUCTION In January 2005, during the annual meeting of the Portuguese Society of Endocrinology, Diabetes and Metabolism, a questionnaire on the treatment and follow-up of differentiated thyroid carcinoma (DTC) was given to attendants. The aim of this study was to present the surveys results. METHODS The questionnaire addressed the following issues: the surgical treatment of the gland and cervical lymph nodes, whole body scan and ablation with (131)I, suppression with levothyroxine, and treatment of recurrence and metastases. Fifty-four completed questionnaires were obtained (79% from clinical endocrinologists). RESULTS When DTC is diagnosed, 67% of respondents reported that total thyroidectomy is always performed. When the diagnosis is made postsurgically, completion of thyroidectomy is recommended by 70% of respondents for papillary carcinoma, by 67% for papillary microcarcinoma and by 44% for minimally invasive follicular carcinoma. Most respondents recommend lymph node dissection if the nodes are involved; 61% systematically perform whole body scan with (131)I after surgery. Twenty-eight percent routinely perform ablation of the thyroid, and 59% request adjuvant radioiodine ablation of the thyroid bed if there is (131)I uptake, if thyroglobulin is increased, or if risk factors are present. The most commonly used ablation dose is 100 mCi. Consensus on the degree of TSH suppression is lacking. Twenty-two percent of the respondents recommend surgery as the first therapeutic option in recurrence and metastases, while 57% prefer (131)I for the treatment of local recurrence. When thyroglobulin levels remain high and the results of (131)I scanning are negative, 50% choose computed tomography scan for the diagnosis of disease recurrence. CONCLUSIONS The wide variability of responses in this survey and the significant percentage (11 to 41%) of non-responders demonstrates the lack of uniformity in the treatment protocols for DCT in Portugal. According to the published guidelines and the responses to a similar survey performed in Spain, the widest differences are mainly found in lymph node dissection and the treatment of disease recurrence.Introduccion En enero de 2005, durante la reunion anual de la Sociedad Portuguesa de Endocrinologia, Diabetes y Metabolismo, se entrego a los medicos presentes una encuesta sobre el modo de actuacion en el tratamiento y el seguimiento del carcinoma diferenciado de tiroides. Es objetivo de este trabajo dar a conocer los resultados de esa encuesta. Metodos El cuestionario versaba esencialmente sobre los siguientes puntos: tratamiento quirurgico de la glandula y cadenas ganglionares, gammagrafia y ablacion con 131I, supresion con levotiroxina, tratamiento de las recidivas y metastasis. Se obtuvieron 54 respuestas (el 79% de los endocrinologos). Resultados Ante el diagnostico de carcinoma diferenciado de tiroides la tiroidectomia total es siempre preferida por el 67% de los encuestados. La totalizacion, en caso de diagnostico posquirurgico, es recomendada por el 70% en el carcinoma papilar, por el 67% en el microcarcinoma papilar y por el 44% en el folicular con invasion minima. La gran mayoria recomienda vaciamiento ganglionar si los ganglios estan afectados; el 61% realiza sistematicamente gammagrafia con 131I tras la cirugia; el 28% de los interrogados hacen ablacion de restos tumorales, ademas del 59% que la hacen si hay captacion de 131I en el lecho tiroideo, si la tiroglobulina esta aumentada o si hay factores de riesgo; 100 mCi es la dosis mas usada. No hubo unanimidad en relacion con el grado de supresion de tirotropina. En caso de recidiva y metastasis, apenas el 22% de los encuestados refiere la cirugia como primera opcion terapeutica y el 57% prefiere el 131I en el tratamiento de la recidiva local. Mas del 50% escogio la tomografia computarizada para el diagnostico de recidiva de enfermedad en los casos en que la tiroglobulina permanece elevada y la gammagrafia corporal con 131I fuese negativa. Conclusiones La gran variabilidad de respuestas en este cuestionario y un porcentaje significativo (11-41%) de no respondedores evidencian la falta de uniformidad de los protocolos de tratamiento del carcinoma de tiroides en Portugal. Segun las guias publicadas y las respuestas a un cuestionario semejante realizado en Espana, las grandes diferencias de actuacion surgen principalmente en la cuestion del vaciamiento ganglionar y en el tratamiento de la recidiva de la enfermedad.

Comparative electron temperature measurements of Thomson scattering and electron cyclotron emission diagnostics in TCABR plasmas.

We present the first simultaneous measurements of the Thomson scattering and electron cyclotron emission radiometer diagnostics performed at TCABR tokamak with Alfvén wave heating. The Thomson scattering diagnostic is an upgraded version of the one previously installed at the ISTTOK tokamak, while the electron cyclotron emission radiometer employs a heterodyne sweeping radiometer. For purely Ohmic discharges, the electron temperature measurements from both diagnostics are in good agreement. Additional Alfvén wave heating does not affect the capability of the Thomson scattering diagnostic to measure the instantaneous electron temperature, whereas measurements from the electron cyclotron emission radiometer become underestimates of the actual temperature values.

Reconstruction activities and first results from the Thomson scattering diagnostic on the TCABR tokamak

An incoherent and infrared Thomson scattering diagnostic (ITS) was transferred from ISTTOK (Lisboa) and reconstructed on TCABR (S. Paulo). In the first phase of this international collaboration, the diagnostic uses a Neodymium:Glass laser with up to 10 Joules per laser pulse and a first generation polychromator with three pairs of interference filters and avalanche photodiodes. It measures 90° scattered radiation in a single volume of observation with a single laser pulse to obtain the instant plasma electron temperature. This paper reports the reconstruction activities already carried out and presents the first experimental results. These activities include: new data model performance, laser refurbishing, new laser delivery system, stray-light reduction in the vacuum vessel, new collection lens and relative diagnostic calibration. A long run of experiments with this diagnostic shows consistency and coherence with the other TCABR diagnostics and gives indications to be able to contribute effectively to the Alfven heating program of this tokamak.