The prevalence of goiter and hypothyroidism among school children 6 years after introduction of a mandatory salt iodination program in a severely iodine-deficient area of the West Black Sea region of Turkey.

The objective of the current study was to determine the prevalence and the degree of iodine deficiency after mandatory salt iodization in Yigilca's school-aged children. A total of 806 school children aged 6-19 years were evaluated. The prevalence of goiter in children aged 6-12 and 13-19 years was 20.3 and 23.8%, respectively. The prevalence of hypothyroidism in children aged 6-12 and 13-19 years was 10.4 and 18.9%, respectively. The median serum free tetraiodothyronine (fT4) levels in children aged 6-12 and 13-19-years were 1.16 ng/dL and 0.91 ng/dL, respectively. The median urinary iodine concentration levels in children aged 6-12 and 13-19 years were 83 µg/l and 78 µg/l, respectively. The frequency of autoimmune thyroid disease was 2.1% in Yigilca's SAC. Goiter and iodine deficiency problems remain in rural areas of the West Black Sea Region of Turkey.

Do baby wet wipes change periurethral aerobic flora?

There is massive enteric bacterial colonization in the periurethral region during infancy. Fecal soiling is considered to be responsible for this colonization. We hypothesized that baby wet wipes containing chemical cleansing compounds, which are used for the cleaning of babies after diaper soiling, could be a contributing factor in this colonization. Thus, the effect on periurethral flora of two different methods of baby cleaning was compared. Periurethral culture samples were obtained from 173 infants who were cleaned with baby wet wipes (Group A, n = 96) or water and napkins (Group B, n = 77) after diaper soiling. The colonization of uropathogens and the presence of flora were analyzed. The results of the periurethral cultures were similar in both groups. The rates of uropathogen colonization only, uropathogen and skin flora colonization, and skin flora only or no growth in Groups A and B were 18.7, 61.5, and 19.8%, and 14.3, 66.2, and 19.5, respectively. The differences between the groups were statistically insignificant (P > 0.05); however, there was no significant difference in the frequency of uropathogen isolation between males and females. We therefore concluded that baby wet wipes are as safe as water for the cleaning of babies after diaper soiling.

Is there a relationship between cord blood pregnancy-associated plasma protein-A and birth weight and length?

BACKGROUND: Infants whose mothers had low serum pregnancy-associated plasma protein-A (PAPP-A) in the first trimester were observed to have intrauterine growth retardation. AIM: Suggesting that PAPP-A plays an important role in the availability and activity of insulin-like growth factors (IGFs), which affect growth, we aimed to investigate cord blood PAPP-A levels of infants with different birth lengths and weights. STUDY DESIGN AND OUTCOME MEASURES: The study included 97 full-term, live-birth neonates. After birth, their lengths and weights were measured. Cord blood PAPP-A levels were measured with an ultra sensitive enzyme-linked immunosorbent assay (ELISA). RESULTS: There was a significant negative correlation between cord blood PAPP-A levels and birth weight (r=-0.23; P=0.023) and length (r=-0.24; P=0.016). Using the classification made according to their length, it was found that newborns with short lengths had significantly higher mean PAPP-A levels than neonates with normal and long lengths (P=0.022; P=0.002, respectively), whereas the difference between infants with normal lengths and infants with long lengths was not found to be statistically significant (P>0.05). On the other hand, there was a difference between the mean PAPP-A levels of the neonate groups classified according to weight; however, these differences were not statistically significant (P>0.05). CONCLUSION: We concluded that increased cord blood PAPP-A levels were associated with birth length and weight decreases; however, PAPP-A levels affected birth length more than birth weight.

A novel thyroid hormone receptor-beta mutation that fails to bind nuclear receptor corepressor in a patient as an apparent cause of severe, predominantly pituitary resistance to thyroid hormone.

CONTEXT: Resistance to thyroid hormone (RTH) is a dominantly inherited syndrome of variable tissue hyporesponsiveness to thyroid hormone (TH). OBJECTIVE: We report a newborn who presented with severe RTH (Mkar) with serum TSH 1500 mU/liter and free T(3) greater than 50 pm (normal 3.1-9.4) and free T(4) 25.3 pm (normal 12-22). We hypothesized that the RTH was due to reduced ligand binding and/or abnormal interaction with nuclear cofactors. DESIGN: These were prospective in vivo and in vitro studies. SETTING: The study was conducted at a tertiary care university hospital. PATIENTS: Patients included a newborn child and two other subjects with RTH. INTERVENTION: The effect of various TH-lowering agents in the subject with RTH was studied. In vitro studies including EMSA and mammalian two-hybrid assay as well as in vitro transfection studies were conducted. MAIN OUTCOME MEASURES: Sequencing of the TH receptor (TR)beta and in vitro measurements of receptor-cofactor interaction were measured. RESULTS: Sequencing of the TRbeta demonstrated a de novo heterozygous mutation, 1590_1591insT, resulting in a frameshift producing a mutant TRbeta (mutTR)-beta with a 28-amino acid (aa) nonsense sequence and 2-amino acid carboxyl-terminal extension. The Mkar mutation was evaluated in comparison to three other TRbeta frameshift mutations in the carboxyl terminus. EMSA demonstrated that the Mkar mutTRbeta1 had impaired ability to recruit nuclear receptor corepressor but intact association with silencing mediator of retinoid and thyroid receptor (SMRT). CONCLUSION: Our data suggest that alterations in codons 436-453 in helix 11 result in significantly diminished association with nuclear receptor corepressor but not SMRT. This novel mutTRbeta demonstrates nuclear corepressor specificity that results in severe predominantly pituitary RTH due to impaired release of SMRT.