Manual de Endocrinologia y Metabolismo (Spanish Edition)

Leucopenia y linfocitopenia leucopenia.

Noteworthy

Enfermedades bacterianas causadas por cocos. Trastornos de la personalidad. Esquizofrenia y trastornos asociados. Trastornos de la conducta alimentaria. Enfermedades de la aorta y de sus ramas. Lesiones del pene y del escroto. Anormalidades menstruales y hemorragia uterina anormal.

Enfermedades de la mama. Embarazo y parto normales.

Embarazo de alto riesgo. Enfermedades que complican el embarazo. Cuidados en el posparto. Infecciones de la infancia. The author style to spell out the idea is very unique.

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You can save the actual book in your smart phone. All elements are composed of drawings; thus, children readily accept the task, and it is not difficult for them to maintain their attention. Scale 1 comprises the following subtests: The tests were all administered collectively because of the large number of children involved. This necessitated elimination of the subtests concerning classification, orders, mistakes, and riddles, which are given individually.

The subtests given, therefore, were substitution, maze, identification, and similarities. The tests given compose the abbreviated form Scale 2 is composed of four subtests, all perceptive: In all cases the elements are presented graphically, with no cultural content. The scores obtained in the different subtests of both scales are combined to give a single score, which is then transformed into a score out of or in deviation IQ normal distribution of the IQ, with an arithmetic mean of and an sd of These tests have already been validated for schoolchildren in Spain 22 — A blood sample obtained by venipuncture was taken from all children.

Measurements were made of TSH reference value, 0. Data are represented as percentages, percentiles, means, and sd s. Hypothesis contrast of continuous variables was made by t test for two comparisons or by one- or two-way ANOVA for multiple comparisons. The study was authorized by the relevant health and education authorities, and the parents of all the children attending the school at the time gave written informed consent to the participation of their children in the study.

Vitamin D Receptor Activators and Clinical Outcomes in Chronic Kidney Disease

The study was also approved by the ethics and investigation committee of one of the participating centers. The mean age of the children was The prevalence of goiter was The mean urinary iodine level was There was no significant correlation between urinary iodine levels and FT 3 or FT 4. The mean IQ was The distribution of the IQ of the schoolchildren according to percentile was: There were no significant differences in IQ when the sex, level of education, and presence of goiter were considered Table 2.

The correlations in the boys were not statistically significant. These OR rose to 2. Introduction in the model of other variables, such as education level, presence of goiter, or sex, did not change the strength of the association between IQ and urinary iodine or thyroglobulin levels data not shown. Table 4 shows the risk gradient of having an IQ below the 25th percentile according to urinary iodine level.

Prevalence percentage and risk OR of an IQ below the 25th percentile according to decreasing urinary iodine levels micrograms per liter. Risk OR of an IQ below the 25th percentile according to urinary iodine level exposure variable , calculated from a logistic regression model that included age and sex as confounding variables. As expected, urinary iodine levels were significantly higher in the IQ was significantly higher in children who consumed iodized salt None of the other food groups was related to urinary iodine level or IQ data not shown.

There was no interaction among intake of dairy products, iodized salt, and sex data not shown. The risk of an IQ below the 25th percentile was significantly related to the intake of common vs. Inclusion in the model of sex and age did not change this association Table 6. We found data not shown that 7. Intake of iodized salt or a greater amount of milk reduced the probability of being below this threshold. The strength and significance of this association were unchanged alter adjusting for age and sex.

Numerous studies in populations with iodine deficiency have shown a reduction in the psychomotor ability of children 3 , 8 , Our study confirms this association in a representative sample of schoolchildren from a developed country in southern Europe who were all similar from an ethnic and social viewpoint and who had no associated nutritional problems.

Although the results suggest that the degree of iodine deficiency can be classified as mild, this does not mean that the consequences are mild, as indicated by decreases in IQ and hearing acuity These disorders should not be considered merely mild handicaps in the current competitive environment found in developed nations.

This is an observation appearing more and more frequently from studies in other European countries, where surveys in schoolchildren suggested that iodine deficiency was mild, but the children were affected by iodine deficiency disorders that are not really mild 6 , Previous studies in the same area have shown the main nutritional determinants of urinary iodine in schoolchildren to be intake of iodized salt and amount of dairy products consumed In the present study the highest urinary iodine levels were found in children who consumed iodized salt and those who consumed dairy products at least three times a day.

The association between IQ and urinary iodine levels, on one hand, and between IQ and intake of iodized salt and dairy products, on the other, confirms the nutritional nature of this relation as well as the probable persistence over time of a deficient iodine intake. The possibility that other components of milk, such as amino acids or fatty acids, whose beneficial effect on brain development is known 31 , may influence these results cannot be ruled out, but they are outside the scope of this study. Most children were clinically and analytically euthyroid, according to the reference values and usual clinical criteria.

In fact, no marked changes in TSH, FT 3 , or FT 4 levels are usually found with moderate iodine deficiency, although thyroglobulin levels are increased Just as we found an association between thyroglobulin and IQ in this study, we had previously found a relation between thyroglobulin and auditory threshold in schoolchildren who were socially and geographically very similar to those in the present study This association suggests that the effect of iodine deficiency on IQ is produced by the persistence of thyroid dysfunction, presently subclinical, but which at some point during development fetal or postnatal must have caused damage to brain maturation 2 , 29 , 33 — Numerous clinical and experimental studies have shown the importance of an adequate iodine supply for maturation of the fetal and newborn brain 2 ,