Jodium

Wetenschappelijke naam

Jodium, I, Atoomnummer 53.

Jodium

Jodium is een niet-metalen sporenelement met atoomnummer 53 (91396). Jodium is nodig voor thyroxine (T4) en triiodothyronine (T3) (16747). Jodiumtekort is een algemeen probleem voor de wereldgezondheid (7135). De meest erkende vorm van deficiëntie is struma, een vergrote schildklier. Wereldwijd wordt jodiumdeficiëntie beschouwd als de meest voorkomende te voorkomen oorzaak van mentale retardatie (16747). Vroeg in de twintigste eeuw was jodiumtekort gebruikelijk in de VS en Canada, maar de toevoeging van jodium aan zout heeft de volksgezondheid verbeterd (7135). Dieetbronnen van jodium anders dan gejodeerd zout omvatten zeewier en andere producten uit de zee, eieren en koemelk (91396, 91398).

Gebruik

Oraal wordt jodium gebruikt voor endemische struma, schildklierstorm, hyperthyreoïdie, nodulair struma, stralingsnoodgeval geassocieerd met radioactieve jodiden, cutane sporotrichose, mastalgie en fibrocystische borstziekte. Het wordt ook gebruikt voor gewichtsverlies, het voorkomen van borstkanker, diabetes, hart- en vaatziekten, oculaire aandoeningen en als slijmoplossend middel. Het is ook gebruikt voor de behandeling van kanker, miltvuur en syfilis.

Topisch wordt jodium gebruikt voor dermatitis, erythema nodosum, erythema multiforme, eczeem, psoriasis, als antisepticum, ter voorkoming van mucositis, wondgenezing en voor diabetische voet- en veneuze beenulcera. Jodium wordt ook plaatselijk in de mond aangebracht voor parodontitis en om bloeding geassocieerd met extractie te verminderen. Het wordt ook gebruikt om de keel te spoelen om de symptomen van longontsteking te verminderen.

Oogheelkundig wordt jodium gebruikt om conjunctivitis en corneale ulcera te voorkomen.

Intravaginaal wordt jodium gebruikt om post-keizersnede endometritis te voorkomen.

Bij renale bekkeninstillatiesclerotherapie wordt jodium gebruikt voor chylurie.

Jodium wordt ook gebruikt voor waterzuivering.

Veiligheid

WAARSCHIJNLIJK VEILIG: indien oraal en geschikt gebruikt. Jodium is veilig in hoeveelheden die het toelaatbare hogere inname-niveau (UL) van 1100 mcg per dag niet overschrijden (7135). Hogere doses kunnen op een veilige manier therapeutisch worden gebruikt met geschikte medische controle (2197, 7080). In sommige delen van de wereld, zoals Japan, wordt de dagelijkse voedingsinname geraamd op 5280 mcg tot 13.800 mcg zonder nadelige gevolgen (16747). Wanneer plaatselijk en passend gebruikt, als een 2% -oplossing. Een jodiumoplossing van 2% is een door de FDA goedgekeurd recept (15).

MOGELIJK ONZEKER: bij orale toediening in hoge doses. Vertel patiënten om langdurig gebruik van doses te vermijden die de UL van 1100 mcg per dag overschrijden zonder de juiste medische supervisie. Er bestaat bezorgdheid dat een hogere inname het risico op bijwerkingen zoals schildklierstoornissen, evenals thyroïditis, papillaire papillaire kanker, thyrotoxicose en atriale fibrillatie kan verhogen (7135, 55962, 56013). In sommige delen van de wereld, zoals Japan, wordt de dagelijkse voedselinname echter geschat op 5280 mcg tot 13.800 mcg zonder nadelige gevolgen (16747).

KINDEREN: WAARSCHIJNLIJK VEILIG: bij oraal en passend gebruik (7135). Jodium is veilig in hoeveelheden die de UL van 200 mcg per dag niet overschrijden voor kinderen van 1 tot 3 jaar, 300 mcg per dag voor kinderen van 4 tot 8 jaar, 600 mcg per dag voor kinderen van 9 tot 13 jaar en 900 mcg per dag voor adolescenten (7135). Bij topicale toepassing als een 2% oplossing (15). Jodium is een door de FDA goedgekeurd recept. MOGELIJK ONZEKER: bij orale toediening in hoge doses. Vertel patiënten om langdurig gebruik van doses te voorkomen die de UL van 200 mcg per dag overschrijden voor kinderen van 1 tot 3 jaar, 300 mcg per dag voor kinderen van 4 tot 8 jaar, 600 mcg per dag voor kinderen van 9 tot 13 jaar en 900 mcg per dag voor adolescenten (7135). Een hogere inname kan schildklierproblemen veroorzaken (7135).

ZWANGERSCHAP EN LACTATIE: WAARSCHIJNLIJK VEILIG: indien oraal en op de juiste manier gebruikt. Jodium is veilig in hoeveelheden die de UL van 1100 mcg per dag niet overschrijden (7135). Jodium inname moet toenemen tijdens de zwangerschap en borstvoeding en adequate innames moeten beginnen zodra een patiënt zich ervan bewust is dat ze zwanger is (17920). Bij topicale toepassing als een 2% -oplossing (15). Jodium is een door de FDA goedgekeurd recept. MOGELIJK ONZEKER: bij orale toediening in hoge doses. Vertel patiënten om te voorkomen dat de UL van 1100 mcg per dag of 900 mcg per dag wordt overschreden voor zwangere vrouwen van 14 tot 18 jaar. Een hogere inname kan een schildklierdisfunctie veroorzaken (7135). Ook hogere inname tijdens de zwangerschap veroorzaakt verhoogde jodiumgehaltes in moedermelk en babybloedmonsters. Ook is een hogere inname van jodium tijdens de zwangerschap in verband gebracht met een verhoogd risico op aangeboren hypothyreoïdie en verminderde metaal- en lichamelijke ontwikkeling bij het nageslacht (56089, 91390, 91394, 91395).

Effectiviteit

Jodiumtekort: het gebruik van jodiumsupplementen, inclusief gejodeerd zout, is effectief voor het verbeteren van de jodiumstatus bij patiënten met jodiumdeficiëntiestoornissen. Ook kan jodiumsuppletie de manifestaties behandelen die geassocieerd zijn met jodiumdeficiëntie, waaronder endemische kropgeiten, schildklierindices en cognitieve functie bij kinderen (16747, 55919, 55957, 55976, 91399).

Blootstelling aan straling: inname van kaliumjodide is effectief voor het voorkomen van opname door de schildklier van radioactief jodium (7517, 7518). Het is echter niet effectief voor algemene bescherming tegen straling.

De doses kaliumjodide beschermen ongeveer 24 uur. Daarom moet het dagelijks worden ingenomen totdat het risico van blootstelling aan straling niet langer bestaat (17575, 17576). In de VS zijn door Food & Drug Administration (FDA) goedgekeurde kaliumjodideproducten o.a. Iosat, ThyroSafe en ThyroShield. In Canada is RadBlock goedgekeurd (17575).

Kaliumjodide mag alleen in geval van stralingsgevaar worden gebruikt en niet als profylaxe in geval van stralingsnoodgevallen.

Schildklieraandoeningen: jodium oraal innemen kan schildklierstorm en schildklierknobbeltjes verbeteren (15, 92699). Voor de behandeling van schildklieronweer adviseren de American Thyroid Association (ATA) en de American Association of Clinical Endocrinologists (AACE) een multimodaliteitsaanpak waarbij elke zes uur vijf druppels van een verzadigde oplossing van kaliumjodium wordt ingenomen (92699). Voor de behandeling van schildkliernodus kan jodium in combinatie met thyroxine worden ingenomen. De combinatie lijkt beter te werken dan alleen thyroxine. Het innemen van gejodeerd zout 200 mcg dagelijks naast thyroxine 1,5 mcg per kg dagelijks na een operatie voor goedaardige nodulaire schildklierziekte lijkt de schildklierrest te verkleinen met 39,7% in vergelijking met een 10,2% vermindering bij patiënten die thyroxine alleen kregen (55927). Ook lijkt het innemen van jodium als kaliumjodide 150 mcg/dag in combinatie met thyroxine 50-100 mcg/dag op basis van de behoefte gedurende 12 maanden het knobbeltjesvolume te verminderen met 17,3% versus 7,3% in de groep met alleen thyroxine (91392).

Veneuze beenzweren: analyse van klinisch bewijs suggereert dat het aanbrengen van cadexomer jodium op veneuze beenulcera gedurende 4-6 weken in combinatie met compressie de snelheid van volledige genezing verhoogt in vergelijking met standaardbehandeling. Ook lijkt toepassing van povidon-jodium plus compressie net zo effectief als amoxicilline plus compressie bij het bevorderen van de genezing van ulcera bij patiënten met veneuze beenulcera en kan het de terugkeer van infectie verminderen (56076).

Conjunctivitis: analyse van klinisch bewijs suggereert dat povidon-jodiumoplossingen effectiever zijn dan zilvernitraat bij het verlagen van het risico op neonatale conjunctivitis. Povidon-jodiumoplossingen zijn echter niet effectiever dan erytromycine of chlooramfenicol (56084).

Diabetische voetzweren: topisch jodium kan nuttig zijn voor de behandeling van diabetische voetzweren (2200).

Endometritis: klinisch onderzoek suggereert dat het gebruik van een chirurgische wasoplossing die povidon-jodium bevat (1% tot 10% vaginaal onmiddellijk voor de behandeling met Cesarean), het risico op postoperatieve endometritis met ongeveer 45% vermindert in vergelijking met controlegroepen, vooral bij vrouwen die een cesare-afgifte met gescheurde membranen ondergaan (56080).

Fibrocystische borstziekte: klinisch onderzoek toont aan dat het nemen van jodium in de vorm van natriumjodide, eiwitgebonden jodide of moleculair jodium de subjectieve en objectieve metingen van fibrocystische borstziekte aanzienlijk verbetert. Moleculair jodium lijkt effectiever en beter getolereerd te worden dan de andere vormen (2197).

Mastalgia: het nemen van tabletten met moleculair jodium van 3000-6000 mcg per dag gedurende 5 maanden vermindert pijn, gevoeligheid en nodulairiteit bij vrouwen met cyclische mastalgie in vergelijking met placebo. Een lagere dosis van 1500 mcg per dag lijkt niet gunstig (55960).

Orale mucositis: topisch gebruik van jodium kan orale mucositis door chemotherapie voorkomen (2198, 2199).

Parodontitis: analyse van klinisch onderzoek suggereert dat het spoelen met povidon-jodium van 0,1% tot 10% tijdens schalen en wortelschaven bescheiden de pocketdiepte vermindert bij patiënten met chronische parodontitis in vergelijking met controle (56072).

Chirurgie: sommige analyses van klinisch bewijs suggereren dat intraoperatieve toediening van povidon-jodium het risico op een infectie op de lokale site met ongeveer 40% vermindert in vergelijking met controle (56088). Ander voorlopig klinisch bewijs suggereert dat het irrigeren van de darm met povidon-jodium 10% (Betadine) voorafgaand aan resectie van groot darmcarcinoom het risico op wondsepis vermindert in vergelijking met waterirrigatie (56153). Echter, enige analyse van klinisch bewijs suggereert dat povidon- jodium antisepsis minder effectief is dan chloorhexidine bij het voorkomen van chirurgische plaatsinfecties wanneer het preoperatief wordt toegepast op de operatieplaats (55961, 56087, 56091).

Bloeden: voorlopig klinisch onderzoek suggereert dat irrigatie van extractiebuizen met povidon-jodium 1% bloeding bij een groter aantal patiënten na tandextractie voorkomt, in vergelijking met een zoutoplossing (56011).

Chyluria: voorlopig klinisch onderzoek suggereert dat het gebruik van povidon-jodium 0,2% -oplossing als een sclerosant bij patiënten met chylurie die nier-bekkeninstillatiesclerotherapie (RPIS) ondergaan, even effectief is als 1% zilvernitraat voor het behandelen en voorkomen van herhaling van chyluria (55970).

Longontsteking: voorlopig klinisch onderzoek suggereert dat het regelmatig spoelen van de keel met 20 ml povidonjodium (10% oplossing) de met het beademingsapparaat geassocieerde pneumonie vermindert bij patiënten met ernstig hoofdtrauma in vergelijking met spoelen met een zoutoplossing (56003).

Wondgenezing: er is enige interesse in het gebruik van jodiummiddelen om wondgenezing te bevorderen. Analyse van klinisch bewijs suggereert dat topisch jodium, als cadexomeerjodium of povidon-jodium, beter is dan niet-antiseptische verbanden en sommige antiseptische middelen, zoals zilversulfadiazine, bij het verminderen van de wondgrootte. Jodium lijkt echter minder effectief te zijn dan lokale antibiotica zoals rifamycine (56083).

Dosering & gebruik

Volwassen

Oraal

Algemeen: het National Institute of Medicine heeft als ADH voor volwassenen: 150 mcg/dag (7135). Voor zwangere vrouwen bedraagt ​​de ADH 220 mcg/dag en vrouwen die borstvoeding geven, 290 mcg/dag (7135). Aanvaardbare hoogste inname niveaus (UL) voor de inname van jodium zijn ingesteld voor volwassenen inclusief zwangere en zogende vrouwen: 1100 mcg/dag (7135).

Cutane sporotrichosis: een verzadigde oplossing van kaliumjodide oraal, beginnend met een dosis van vijf tot tien druppels driemaal per dag en verhoogd tot 30-50 druppels driemaal per dag gedurende 2-3 maanden (1763). In sommige gevallen werd de verzadigde oplossing van kaliumjodium samen met terbinafine 250 mg tweemaal daags ingenomen (17563).

Fibrocystische borstziekte: moleculair jodium 70-90 mcg/kg per dag gedurende 4-18 maanden is gebruikt (2197).

Jodiumtekort: om het jodiumtekort bij de meeste mensen te behandelen en te voorkomen, bevelen de Wereldgezondheidsorganisatie (WHO), het Kinderfonds van de Verenigde Naties (UNICEF) en de Internationale Raad voor de controle van jodiumtekortstoornissen (ICCIDD) aan dat gejodeerd zout dat 20- 40 mg/kg jodium bevat wordt gebruikt. In gebieden met een zoutconsumptie van minder dan 10 gram per persoon per dag, moet de concentratie van jodium in gejodeerd zout mogelijk hoger zijn. Het wordt aanbevolen om de consumptie van gejodeerd zout aan te passen om ervoor te zorgen dat de bloedspiegels van jodium variëren van 100-200 mcg/L (92698). Bij zwangere of zogende vrouwen kan aanvullende jodiumsuppletie noodzakelijk zijn. Voor deze patiënten bevelen WHO/UNICEF/ICCIDD-richtlijnen het gebruik van jodiumsupplementen aan die 250 mg/dag jodium of een eenmalige joodse dosis 400 mg jodium bevatten (92698).

Mastalgie: moleculair jodium 3000-6000 mcg dagelijks gedurende 5 maanden is gebruikt (55960).

Stralingsblootstelling: voor stralingsnoodgevallen dient kaliumjodide (KI) vlak voor of zo snel mogelijk na blootstelling te worden ingenomen. KI wordt gedoseerd afhankelijk van de hoeveelheid blootstelling aan straling en de leeftijd. Voor zwangere of zogende vrouwen wordt KI gegeven als de blootstelling aan straling 5 centigrays (cGy) of meer is. De dosis is KI 120 mg voor zwangere of zogende vrouwen. Voor volwassenen van 18 tot 40 jaar met blootstelling aan 10 cGy of meer, wordt KI 130 mg gegeven. Voor volwassenen ouder dan 40 jaar met blootstelling aan 500 cGy of meer, wordt KI 130 mg gegeven (7518, 17575). De doses kaliumjodide beschermt ongeveer 24 uur. Daarom moet het dagelijks worden ingenomen totdat het risico van blootstelling aan straling niet langer bestaat (17575, 17576). In de VS zijn FDA-goedgekeurde kaliumjodideproducten onder meer Iosat, ThyroSafe en ThyroShield. In Canada is RadBlock goedgekeurd (17575). Kaliumjodide mag alleen in geval van stralingsgevaar worden gebruikt en niet als profylaxe in geval van stralingsnoodgevallen.

Schildklieraandoeningen: voor de behandeling van schildklierbestrijding adviseren de American Thyroid Association (ATA) en de American Association of Clinical Endocrinologists (AACE) een multimodaliteitsaanpak waarbij elke zes uur vijf druppels van een verzadigde oplossing van kaliumjodium wordt ingenomen (92699). Voor het verminderen van de grootte van schildkliernodules werd gejodeerd zout 150-200 mcg dagelijks, in combinatie met thyroxine 1,5 mcg/kg per dag genomen na een operatie voor goedaardige nodulaire schildklieraandoeningen of 50-100 mcg/dag op basis van behoeften, gebruikt tot 12 maanden (56043, 91392).

Topisch

Bloeding: Irrigatie van contactdozen met povidon-jodium 1% oplossing na tandextractie is gebruikt (56011).

Chyluria: Zes tot 10 ml povidon-jood 0,2% -oplossing, ingebracht in het bekkenstelsel met behulp van een katheter om de acht uur voor een totaal van negen doses, is gebruikt (55970).

Diabetische voetzweren: Topische jodium 0,9% zalf gedurende 12 weken is gebruikt (2200).

Orale mucositis: Povidon-jodiumoplossing (Betaisodona Mund-Antiseptikum, Mundipharma GmbH) 100 ml, gebruikt als mondspoeling gedurende drie minuten viermaal daags beginnend bij het begin van de radiotherapie en doorlopend tot een week erna (2199).

Parodontitis: Povidon-jood 0,1% tot 10% oplossing, gebruikt als mondspoeling tijdens scaling en wortelschaven, is gebruikt (56072).

Longontsteking: 20 ml van een 10-procents povidon-jodiumoplossing (Betadine 10% -oplossing pour bain de bouche, Viatris Manufacturing, Mérignac, Frankrijk) gereconstitueerd in 60 ml steriel water, gebruikt om de keel om de 4 uur te spoelen, is gebruikt tijdens de beademing in het ziekenhuis (56003).

Operatie: Povidon-jodium spray, aangebracht voor of na wondsluiting, en povidon-jodium 0.35% tot 10% oplossing, aangebracht via irrigatie gedurende één tot drie minuten vóór of na wondsluiting, zijn gebruikt (56088). Ook is een specifieke 10% -oplossing van povidon-jood (Betadine) gebruikt, toegepast via irrigatie voorafgaand aan een belangrijke resectie voor een groot darmcarcinoom, gebruikt (56153).

Veneuze beenulcera: topicale toediening van cadexomerjodium aan veneuze beenulcera gedurende 4-6 weken werd gebruikt in combinatie met compressie (56076). Ook zijn povidonjodiumformuleringen, waaronder 10% oplossing, 10% zalf en 2,5% droge poederspray, gebruikt in combinatie met compressie (56076).

Vaginaal

Endometritis: een chirurgische scrub-oplossing.

Kinderen

Oraal

Algemeen: Het National Institute of Medicine heeft een adequate inname (AI) van jodium voor zuigelingen ingesteld: 0 tot 6 maanden, 110 mcg/dag en 7 tot 12 maanden, 130 mcg/dag (7135). Voor kinderen is de RDA vastgesteld: kinderen van 1 tot 8 jaar, 90 mcg/dag; 9 tot 13 jaar, 120 mcg/dag; 14 en ouder, 150 mcg/dag (7135). Voor zwangere meisjes bedraagt ​​de RDA 220 mcg/dag en meisjes die borstvoeding geven, 290 mcg/dag (7135). Aanvaardbare bovenste inname niveaus (UL) voor de inname van jodium zijn ingesteld: kinderen van 1 tot 3 jaar, 200 mcg/dag; 4 tot 8 jaar, 300 mcg/dag; 9 tot 13 jaar, 600 mcg/dag; 14 tot 18 jaar (inclusief zwangerschap en borstvoeding), 900 mcg/dag (7135).

Cutane sporotrichose: een verzadigde oplossing van kaliumjodide (SSKI), beginnend met drie druppels of 150 mg per dag en elke dag opgeslorpt met drie druppels gedurende ongeveer 33 dagen of tot klinische respons of tekenen van toxiciteit bij kinderen en adolescenten (17561).

Jodiumtekort: om het jodiumtekort bij de meeste mensen te behandelen en te voorkomen, bevelen de Wereldgezondheidsorganisatie (WHO), het Kinderfonds van de Verenigde Naties (UNICEF) en de Internationale Raad voor de controle van jodiumtekortstoornissen (ICCIDD) aan dat gejodeerd zout dat 20- 40 mg/kg jodium wordt gebruikt. In gebieden met een zoutconsumptie van minder dan 10 gram per persoon per dag, moet de concentratie van jodium in gejodeerd zout mogelijk hoger zijn. Het wordt aanbevolen om de consumptie van gejodeerd zout aan te passen om ervoor te zorgen dat de bloedspiegels van jodium variëren van 100-200 mcg/L (92698). Bij kinderen van 7 maanden tot 2 jaar kan jodiumsuppletie noodzakelijk zijn als gejodeerd zout niet beschikbaar is. In die gevallen bevelen de richtlijnen van de WHO/UNICEF/ICCIDD aan om te worden aangevuld met jodiumsupplementen die 90 mg/dag jodium of een eenmalige joodse dosis 200 mg per dag leveren (92698).

Stralingsblootstelling: Voor stralingsnoodgevallen dient kaliumjodide (KI) vlak voor of zo snel mogelijk na blootstelling te worden ingenomen. KI wordt gedoseerd afhankelijk van de hoeveelheid blootstelling aan straling en de leeftijd. Voor baby's, kinderen en adolescenten wordt KI gegeven als de blootstelling aan straling 5 centigrays (cGy) of meer is. Voor een geboorte tot 1 maand is de dosis KI 16 mg; voor baby's en kinderen ouder dan 1 maand tot 3 jaar, 32 mg; voor kinderen van 3 tot 12 jaar, 65 mg; en voor adolescenten van 12 tot 18 jaar, 65 mg of 120 mg als de adolescent de volwassen grootte nadert (7518, 17575). De doses kaliumjodide beschermt ongeveer 24 uur. Daarom moet het dagelijks worden ingenomen totdat het risico van blootstelling aan straling niet langer bestaat (17575, 17576). In de VS zijn FDA-goedgekeurde kaliumjodideproducten onder meer Iosat, ThyroSafe en ThyroShield. In Canada is RadBlock goedgekeurd (17575). Kaliumjodide mag alleen in geval van stralingsgevaar worden gebruikt en niet als profylaxe in geval van stralingsnoodgevallen.

Oogheelkundige

Conjunctivitis: Povidon-jodium 2,5% oogdruppeloplossing is kort na de geboorte toegediend aan kinderen (56194).

Bijwerkingen

Algemeen: oraal wordt jodium goed verdragen wanneer het wordt ingenomen in hoeveelheden die het Tolerable Upper Intake Level (UL) niet overschrijden of wanneer het therapeutisch wordt gebruikt met geschikte medische monitoring (2197, 7080, 7135). Bewijs uit klinisch onderzoek suggereert dat, wanneer ingenomen als een verzadigde oplossing van kaliumjodide (SSKI), de meest voorkomende bijwerkingen misselijkheid (14%) en buikpijn (14%) zijn. Andere vaak voorkomende bijwerkingen zijn rhinorrhea (11%), hoofdpijn (7%), metaalsmaak (4%) en diarree (4%) (17561). Deze bijwerkingen kunnen worden geminimaliseerd door snelle dosisverhogingen te vermijden (17574).

Sommige mensen denken dat ze allergisch zijn voor jodium. Een dergelijke diagnose is echter misleidend. Vaak zijn mensen met "jodiumallergie" eigenlijk allergisch voor jodium bevattende voedingsmiddelen of medicijnen en het eigenlijke allergeen is een ander middel zoals zeevruchtenproteïnen of radiocontrastmedia (93001). Sommige mensen kunnen echter overgevoelig zijn voor jodium. Symptomen van dergelijke overgevoeligheid kunnen zijn angio-oedeem, cutane en slijmvliesbloedingen, koorts, artralgie, lymfeklieruitbreiding, eosinofilie, urticaria, erytheem en trombotische trombocytopenische purpura (15, 17561). Andere gemelde bijwerkingen zijn onder meer kaliumtoxiciteit, metabole acidose, pustuleuze psoriasis en vasculitis (17574). Een dergelijke gevoeligheid is echter zeer zeldzaam (93001).

Topisch gezien kan jodium vlekken op de huid veroorzaken, de weefsels irriteren en bij sommige personen sensibilisatie veroorzaken (15). Jodiumverbrandingen worden geassocieerd met de toepassing van een 7% hydroalcoholische oplossing (15). Povidon-jodium kan contactdermatitis of irriterende reacties bij sommige mensen veroorzaken. In zeer zeldzame gevallen is povidon-jodium met anafylaxie geassocieerd, maar dit effect is niet bewezen door jodium (93001).

Interactie

Medicijnen

ACE-REMMERS (ACEI's)

ACE-remmers kunnen de kaliumspiegel verhogen. Gelijktijdig gebruik van deze geneesmiddelen met kaliumjodide verhoogt het risico op hyperkaliëmie (17574). ACE-remmers omvatten benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), en trandolapril (Mavik).

AMIODARONE (Cordarone)

Amiodaron bevat 37,3% jodium en kan het jodiumgehalte verhogen. Gelijktijdig gebruik met jodium kan het risico op buitensporige jodiumspiegels verhogen en de schildklierfunctie negatief beïnvloeden (7135, 17574). Controleer de schildklierfunctie.

ANGIOTENSIN RECEPTOR BLOCKERS (ARB's)

ARB's kunnen de kaliumspiegel verhogen. Gelijktijdig gebruik van deze geneesmiddelen met kaliumjodide verhoogt het risico op hyperkaliëmie (17574). ARB's zijn losartan (Cozaar), valsartan (Diovan), irbesartan (Avapro), candesartan (Atacand), telmisartan (Micardis) en eprosartan (Teveten).

ANTITHYROIDE DRUGS

Gelijktijdig gebruik van thyreostatica met jodium kan leiden tot bijkomende hypothyreoïde activiteit en kan hypothyreoïdie veroorzaken (2138, 17574).

LITHIUM

Lithium kan de schildklierfunctie remmen. Gelijktijdig gebruik met jodium kan additieve of synergetische hypothyreoïde effecten hebben (17574). Controleer de schildklierfunctie.

POTASSIUM-SPARING DIURETICS

Kaliumsparende diuretica kunnen de kaliumspiegel verhogen. Gelijktijdig gebruik van kaliumjodide met kaliumsparende diuretica verhoogt het risico op hyperkaliëmie (17574). Kaliumsparende diuretica omvatten spironolacton (Aldactone), Triamterene (Dyrenium) en amiloride (Midamor).

Kruiden en supplementen

Geen bijwerkingen bekend.

Voedsel

KRUISBLOEMIGE GROENTEN: Goitrogenen, die aanwezig zijn in ruwe kruisbloemige groenten, kunnen de opname van jodium door de schildklier verstoren (20777).

Lab testen

SCHILDKLIER HORMONEN: Overmatige inname van jodium kan het schildklierhormoon in het serum verlagen en resulteren in verhoogde niveaus van thyroïdstimulerend hormoon (TSH) (7135).

Ziektes

AUTOIMMUNE: Mensen met AITD kunnen een verhoogde gevoeligheid hebben voor bijwerkingen van jodium (7135, 91393).

DERMATITIS HERPETIFORMIS: Van jodium is bekend dat het dermatitis herpetiformis verergert (17574, 17575, 20758). Vermijd jodium bij deze patiënten.

BESCHERMING SCHILDKLIER: Langdurig gebruik of overmatige hoeveelheden jodiden kunnen hyperplasie van de schildklier, schildklieradenoom, ziekte van Graves, struma en hypothyreoïdie veroorzaken of verergeren (15, 91393).

Werkingsmechanisme

Algemeen: jodium is een essentiële voedingsstof voor de mens. Het jodiumgehalte van de meeste voedingsmiddelen is laag en wordt beïnvloed door agrarische factoren zoals bodemkwaliteit en klimaat. De meeste jodium wordt gevonden in de oceanen. Kustgronden hebben hogere bodemconcentraties van jodium dan inlandse bodems. Zeedieren concentreren jodium uit zeewater en hebben een hoger gehalte dan de meeste andere voedingsmiddelen (7135). Zeewier, dat veel wordt geconsumeerd in Aziatische culturen, bevat ook een hoge concentratie jodium (16747). Bewerkte voedingsmiddelen kunnen toevoegen aan jodium in de voeding als gevolg van de toevoeging van jodaat aan zout. In Noord-Amerika is de gemiddelde dagelijkse inname van jodium 167 mcg. In andere regio's, zoals Japan, wordt de gemiddelde dagelijkse inname geschat op ongeveer 5280 mcg tot 13.800 mcg (16747). Ongeveer 90% van het ingenomen jodium wordt geabsorbeerd.

De schildklier concentreert bij de mens ongeveer 30% van het jodium van het lichaam voor de synthese van schildklierhormonen. Kleine hoeveelheden jodium worden aangetroffen in de speekselklieren, borst, choroïde plexus en maagslijmvliesweefsels. Jodium wordt voor 90% door de nieren uitgescheiden (7135, 1774). Jodium omvat 65% thyroxine (T4) en 59% triiodothyronine (T3). Deze jodiumrijke schildklierhormonen regelen veel biochemische reacties, met name eiwitsynthese en enzymatische processen. Bij mensen met hyperthyreoïdie remt jodium de afgifte en synthese van het schildklierhormoon (16747).

De jodiumstatus wordt gemeten met behulp van urine-jodiumniveaus. Niveaus van 50-99 mcg/L worden beschouwd als milde deficiëntie. Urinespiegels van 20-49 mcg/L worden als matige deficiëntie beschouwd. Een niveau van minder dan 20 mcg/L wordt als ernstige tekortkoming beschouwd (16747). Jodiumtekort leidt tot verschillende nadelige resultaten. Het vroegste klinische symptoom van jodiumtekort is laag circulerend schildklierhormoon en schildklierstimulerend hormoon (TSH), gevolgd door vergroting van de schildklier (struma) (7135, 16747, 91398). Jodiumtekort en daaropvolgende hypothyreoïdie kunnen leiden tot anovulatie, onvruchtbaarheid, auto-immune thyreoïditis en zwangerschapshypertensie bij vrouwen. Jodiumtekort gaat ook gepaard met een verhoogd risico op schildklierkanker. Sommige onderzoekers speculeren dat jodiumtekort ook het risico op andere kankers zoals prostaat-, borst-, endometrium- en eierstokkanker kan verhogen (16747). Baby's hebben het meeste jodium per kg lichaamsgewicht nodig; jodium wordt gevonden in hogere niveaus in colostrum versus moedermelk (17920, 91398). Ook moet jodium toenemen tijdens de zwangerschap (17920).

Het schildklierhormoon is verantwoordelijk voor de myelinisatie van het ontwikkelende centrale zenuwstelsel. Als gevolg hiervan wordt jodiumtekort geassocieerd met mentale retardatie en in extreme gevallen cretinisme (7135). De meeste ontwikkelde landen, waaronder de VS en Canada, screenen op hypothyreoïdie bij de geboorte (7135).

Antimicrobiële effecten: wanneer lokaal gebruikt, oxideert jodium organische substraten, waardoor micro-organismen worden gedood (15).

Antioxiderende effecten: in sommige weefsels kan jodium een ​​antioxiderend effect hebben (16747, 91396). Er wordt gedacht dat jodium in aanwezigheid van waterstofperoxide, peroxidase en sommige onverzadigde vetzuren een elektron doneert, waardoor de schade als gevolg van zuurstofvrije radicalen afneemt (91396).

Hemostatische effecten: klinisch onderzoek suggereert dat de povidon-jodiumoplossing helpt bij het stoppen van bloedingen in verband met het trekken van tanden. Dit effect is toegeschreven aan het oxiderende vermogen van jodium, resulterend in corrosie, evenals de verdikking en granulatie-eigenschappen van povidon (56011).

Radioprotectieve effecten: Jodium in de vorm van kaliumjodide kan de ophoping van radioactief jodium en schade aan de schildklier blokkeren of verminderen indien het wordt ingenomen voorafgaand aan of onmiddellijk na blootstelling aan radioactief jodium (7517, 7518).

Ademhalingseffecten: jodidezouten, zoals kaliumjodide, kunnen de secretie van de luchtwegen verhogen en daardoor de slijmviscositeit verlagen, maar er is slechts beperkt ondersteunend bewijs voor dit effect (15).

Bovenstaande monografie is geschreven aan de hand van de onderstaande referenties.

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  • 55927 Carella, C., Mazziotti, G., Rotondi, M., Del, Buono A., Zito, G., Sorvillo, F., Manganella, G., Santini, L., and Amato, G. Iodized salt improves the effectiveness of L-thyroxine therapy after surgery for nontoxic goitre: a prospective and randomized study. Clin Endocrinol.(Oxf) 2002;57(4):507-513.
  • 55928 Qian, M., Yan, Y., Chen, Z., and Wang, D. [Meta-analysis on the relationship between children's intelligence and factors as iodine deficiency, supplement iodine and excessive iodine]. Zhonghua Liu Xing.Bing.Xue.Za Zhi. 2002;23(4):246-249.
  • 55929 Segal, C. G. and Anderson, J. J. Preoperative skin preparation of cardiac patients. AORN J 2002;76(5):821-828.
  • 55931 Moen, M. D., Noone, M. B., and Kirson, I. Povidone-iodine spray technique versus traditional scrub-paint technique for preoperative abdominal wall preparation. Am J Obstet Gynecol. 2002;187(6):1434-1436.
  • 55932 Birnbach, D. J., Meadows, W., Stein, D. J., Murray, O., Thys, D. M., and Sordillo, E. M. Comparison of povidone iodine and DuraPrep, an iodophor-in-isopropyl alcohol solution, for skin disinfection prior to epidural catheter insertion in parturients. Anesthesiology 2003;98(1):164-169.
  • 55933 Lok, C. E., Stanley, K. E., Hux, J. E., Richardson, R., Tobe, S. W., and Conly, J. Hemodialysis infection prevention with polysporin ointment. J Am Soc Nephrol. 2003;14(1):169-179.
  • 55935 Wanner, M. B., Schwarzl, F., Strub, B., Zaech, G. A., and Pierer, G. Vacuum-assisted wound closure for cheaper and more comfortable healing of pressure sores: a prospective study. Scand J Plast.Reconstr.Surg Hand Surg 2003;37(1):28-33.
  • 55936 Kastenbauer, T., Hornlein, B., Sokol, G., and Irsigler, K. Evaluation of granulocyte-colony stimulating factor (Filgrastim) in infected diabetic foot ulcers. Diabetologia 2003;46(1):27-30.
  • 55937 Pitten, F. A., Kiefer, T., Buth, C., Doelken, G., and Kramer, A. Do cancer patients with chemotherapy-induced leukopenia benefit from an antiseptic chlorhexidine-based oral rinse? A double-blind, block-randomized, controlled study. J Hosp.Infect. 2003;53(4):283-291.
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  • 55941 Moreno-Reyes, R., Mathieu, F., Boelaert, M., Begaux, F., Suetens, C., Rivera, M. T., Neve, J., Perlmutter, N., and Vanderpas, J. Selenium and iodine supplementation of rural Tibetan children affected by Kashin-Beck osteoarthropathy. Am J Clin Nutr 2003;78(1):137-144.
  • 55942 Ozeki, S., Asano, M., Minoshima, K., Nishino, Y., Yamada, S., Ito, Y., Tokuyama, K., Kuriyama, M., Ban, Y., and Kawada, Y. [Solitary infected renal cyst: a case report]. Hinyokika Kiyo 1992;38(12):1383-1386.
  • 55943 MORTENSEN, J. D., WOOLNER, L. B., and BENNETT, W. A. Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol.Metab 1955;15(10):1270-1280.
  • 55944 Brabant, G., Bergmann, P., Kirsch, C. M., Kohrle, J., Hesch, R. D., and von zur, Muhlen A. Early adaptation of thyrotropin and thyroglobulin secretion to experimentally decreased iodine supply in man. Metabolism 1992;41(10):1093-1096.
  • 55945 Perez-Fontan, M., Rosales, M., Rodriguez-Carmona, A., Moncalian, J., Fernandez-Rivera, C., Cao, M., and Valdes, F. Treatment of Staphylococcus aureus nasal carriers in CAPD with mupirocin. Adv.Perit.Dial. 1992;8:242-245.
  • 55946 SOOCH, S. S. and RAMALINGASWAMI, V. PRELIMINARY REPORT OF AN EXPERIMENT IN THE KANGRA VALLEY FOR THE PREVENTION OF HIMALAYAN ENDEMIC GOITRE WITH IODIZED SALT. Bull.World Health Organ 1965;32:299-315.
  • 55947 Epstein, J. B., Vickars, L., Spinelli, J., and Reece, D. Efficacy of chlorhexidine and nystatin rinses in prevention of oral complications in leukemia and bone marrow transplantation. Oral Surg Oral Med Oral Pathol 1992;73(6):682-689.
  • 55948 Einenkel, D., Bauch, K. H., and Benker, G. Treatment of juvenile goitre with levothyroxine, iodide or a combination of both: the value of ultrasound grey-scale analysis. Acta Endocrinol.(Copenh) 1992;127(4):301-306.
  • 55949 Eginton, M. T., Brown, K. R., Seabrook, G. R., Towne, J. B., and Cambria, R. A. A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds. Ann Vasc Surg 2003;17(6):645-649.
  • 55950 Yentur, E. A., Luleci, N., Topcu, I., Degerli, K., and Surucuoglu, S. Is skin disinfection with 10% povidone iodine sufficient to prevent epidural needle and catheter contamination? Reg Anesth.Pain Med 2003;28(5):389-393.
  • 55951 Jaya, C., Job, A., Mathai, E., and Antonisamy, B. Evaluation of topical povidone-iodine in chronic suppurative otitis media. Arch Otolaryngol.Head Neck Surg 2003;129(10):1098-1100.
  • 55952 Brauer, V. F., Hentschel, B., and Paschke, R. [Euthyroid thyroid nodules. Aims, results and perspectives concerning drug therapy]. Dtsch Med Wochenschr. 11-7-2003;128(45):2381-2387.
  • 55953 Chen, J. Y. Prophylaxis of ophthalmia neonatorum: comparison of silver nitrate, tetracycline, erythromycin and no prophylaxis. Pediatr Infect.Dis J 1992;11(12):1026-1030.
  • 55954 Lipsky, B. A., Itani, K., and Norden, C. Treating foot infections in diabetic patients: a randomized, multicenter, open-label trial of linezolid versus ampicillin-sulbactam/amoxicillin-clavulanate. Clin Infect.Dis 1-1-2004;38(1):17-24.
  • 55955 Cakmak, M., Caglayan, F., Kilic, D., Kaygusuz, S., Cakmak, A., Ulusoy, S., Ozlu, N., and Ozluk, O. Efficacy of povidone-iodine in preputial antisepsis. Int J Clin Pract 2003;57(9):752-754.
  • 55956 Moues, C. M., Vos, M. C., van den Bemd, G. J., Stijnen, T., and Hovius, S. E. Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial. Wound.Repair Regen. 2004;12(1):11-17.
  • 55957 Angermayr, L. and Clar, C. Iodine supplementation for preventing iodine deficiency disorders in children. Cochrane.Database.Syst.Rev 2004;(2):CD003819.
  • 55958 Burke, B. E., Baillie, J. E., and Olson, R. D. Essential oil of Australian lemon myrtle (Backhousia citriodora) in the treatment of molluscum contagiosum in children. Biomed Pharmacother 2004;58(4):245-247.
  • 55959 Eason, E., Wells, G., Garber, G., Hemmings, R., Luskey, G., Gillett, P., and Martin, M. Antisepsis for abdominal hysterectomy: a randomised controlled trial of povidone-iodine gel. BJOG. 2004;111(7):695-699.
  • 55960 Kessler, J. H. The effect of supraphysiologic levels of iodine on patients with cyclic mastalgia. Breast J 2004;10(4):328-336.
  • 55961 Edwards, P. S., Lipp, A., and Holmes, A. Preoperative skin antiseptics for preventing surgical wound infections after clean surgery. Cochrane.Database.Syst.Rev 2004;(3):CD003949.
  • 55962 Aminorroaya, A., Rohani, S., Sattari, G., Haghighi, S., and Amini, M. Iodine repletion, thyrotoxicosis and atrial fibrillation in Isfahan, Iran. Ann Saudi.Med 2004;24(1):13-17.
  • 55963 Hoffmann, K. K., Weber, D. J., Samsa, G. P., and Rutala, W. A. Transparent polyurethane film as an intravenous catheter dressing. A meta-analysis of the infection risks. JAMA 4-15-1992;267(15):2072-2076.
  • 55964 Crawford, A. G., Fuhr, J. P., Jr., and Rao, B. Cost-benefit analysis of chlorhexidine gluconate dressing in the prevention of catheter-related bloodstream infections. Infect.Control Hosp.Epidemiol. 2004;25(8):668-674.
  • 55965 Fukunaga, A., Naritaka, H., Fukaya, R., Tabuse, M., and Nakamura, T. Povidone-iodine ointment and gauze dressings associated with reduced catheter-related infection in seriously ill neurosurgical patients. Infect.Control Hosp.Epidemiol. 2004;25(8):696-698.
  • 55966 Theos, A. U., Cummins, R., Silverberg, N. B., and Paller, A. S. Effectiveness of imiquimod cream 5% for treating childhood molluscum contagiosum in a double-blind, randomized pilot trial. Cutis 2004;74(2):134-2.
  • 55967 Grabsch, E. A., Mitchell, D. J., Hooper, J., and Turnidge, J. D. In-use efficacy of a chlorhexidine in alcohol surgical rub: a comparative study. ANZ.J Surg 2004;74(9):769-772.
  • 55968 Strippoli, G. F., Tong, A., Johnson, D., Schena, F. P., and Craig, J. C. Antimicrobial agents for preventing peritonitis in peritoneal dialysis patients. Cochrane.Database.Syst.Rev 2004;(4):CD004679.
  • 55969 Ogata, J., Minami, K., Miyamoto, H., Horishita, T., Ogawa, M., Sata, T., and Taniguchi, H. Gargling with povidone-iodine reduces the transport of bacteria during oral intubation. Can.J Anaesth. 2004;51(9):932-936.
  • 55970 Goel, S., Mandhani, A., Srivastava, A., Kapoor, R., Gogoi, S., Kumar, A., and Bhandari, M. Is povidone iodine an alternative to silver nitrate for renal pelvic instillation sclerotherapy in chyluria? BJU.Int 2004;94(7):1082-1085.
  • 55971 Katz, J., Khatry, S. K., Thapa, M. D., Schein, O. D., Kimbrough, Pradhan E., LeClerq, S. C., and West, K. P., Jr. A randomised trial of povidone-iodine to reduce visual impairment from corneal ulcers in rural Nepal. Br J Ophthalmol. 2004;88(12):1487-1492.
  • 55972 Raczynska, K., Kokot, W., Krajka-Lauer, J., and Iwaszkiewicz-Bilikiewicz, B. [Iodine treatment in vitreous degeneration]. Klin Oczna 2004;106(3 Suppl):517-520.
  • 55973 Kaya, A. Z., Turani, N., and Akyuz, M. The effectiveness of a hydrogel dressing compared with standard management of pressure ulcers. J Wound.Care 2005;14(1):42-44.
  • 55974 Culligan, P. J., Kubik, K., Murphy, M., Blackwell, L., and Snyder, J. A randomized trial that compared povidone iodine and chlorhexidine as antiseptics for vaginal hysterectomy. Am J Obstet Gynecol. 2005;192(2):422-425.
  • 55975 Lipp, A. An evaluation of preoperative skin antiseptics. Br J Perioper.Nurs. 2005;15(1):12-19.
  • 55976 Qian, M., Wang, D., Watkins, W. E., Gebski, V., Yan, Y. Q., Li, M., and Chen, Z. P. The effects of iodine on intelligence in children: a meta-analysis of studies conducted in China. Asia Pac.J Clin Nutr 2005;14(1):32-42.
  • 55979 Starr, R. V., Zurawski, J., and Ismail, M. Preoperative vaginal preparation with povidone-iodine and the risk of postcesarean endometritis. Obstet Gynecol. 2005;105(5 Pt 1):1024-1029.
  • 55980 Ostrander, R. V., Botte, M. J., and Brage, M. E. Efficacy of surgical preparation solutions in foot and ankle surgery. J Bone Joint Surg Am 2005;87(5):980-985.
  • 55981 Vehmeyer-Heeman, M., Van den Kerckhove, E., Gorissen, K., and Boeckx, W. Povidone-iodine ointment: no effect of split skin graft healing time. Burns 2005;31(4):489-494.
  • 55982 Kerketta, A. S., Babu, B. V., Rath, K., Jangid, P. K., Nayak, A. N., and Kar, S. K. A randomized clinical trial to compare the efficacy of three treatment regimens along with footcare in the morbidity management of filarial lymphoedema. Trop.Med Int Health 2005;10(7):698-705.
  • 55983 Koshy, G., Kawashima, Y., Kiji, M., Nitta, H., Umeda, M., Nagasawa, T., and Ishikawa, I. Effects of single-visit full-mouth ultrasonic debridement versus quadrant-wise ultrasonic debridement. J Clin Periodontol. 2005;32(7):734-743.
  • 55984 Aksoy, A., Caglayan, F., Cakmak, M., Apan, T. Z., Gocmen, J. S., Cakmak, A., Somuncu, S., and Akman, H. An investigation of the factors that affect surgical hand disinfection with polyvidone iodine. J Hosp.Infect. 2005;61(1):15-19.
  • 55985 Chambers, S. T., Sanders, J., Patton, W. N., Ganly, P., Birch, M., Crump, J. A., and Spearing, R. L. Reduction of exit-site infections of tunnelled intravascular catheters among neutropenic patients by sustained-release chlorhexidine dressings: results from a prospective randomized controlled trial. J Hosp.Infect. 2005;61(1):53-61.
  • 55986 Tsai, Y. C., Lin, M. Y., Chen, S. H., Chung, M. T., Loo, T. C., Huang, K. F., and Lin, L. Y. Vaginal disinfection with povidone iodine immediately before oocyte retrieval is effective in preventing pelvic abscess formation without compromising the outcome of IVF-ET. J Assist.Reprod.Genet. 2005;22(4):173-175.
  • 55987 Furukawa, K., Tajiri, T., Suzuki, H., and Norose, Y. Are sterile water and brushes necessary for hand washing before surgery in Japan? J Nippon Med Sch 2005;72(3):149-154.
  • 55988 Levy, I., Katz, J., Solter, E., Samra, Z., Vidne, B., Birk, E., Ashkenazi, S., and Dagan, O. Chlorhexidine-impregnated dressing for prevention of colonization of central venous catheters in infants and children: a randomized controlled study. Pediatr Infect.Dis J 2005;24(8):676-679.
  • 55989 Cheng, M. T., Chang, M. C., Wang, S. T., Yu, W. K., Liu, C. L., and Chen, T. H. Efficacy of dilute betadine solution irrigation in the prevention of postoperative infection of spinal surgery. Spine (Phila Pa 1976.) 8-1-2005;30(15):1689-1693.
  • 55990 Safdar, N. and Maki, D. G. Risk of catheter-related bloodstream infection with peripherally inserted central venous catheters used in hospitalized patients. Chest 2005;128(2):489-495.
  • 55991 Lakkireddy, D., Valasareddi, S., Ryschon, K., Basarkodu, K., Rovang, K., Mohiuddin, S. M., Hee, T., Schweikert, R., Tchou, P., Wilkoff, B., Natale, A., and Li, H. The impact of povidone-iodine pocket irrigation use on pacemaker and defibrillator infections. Pacing Clin Electrophysiol. 2005;28(8):789-794.
  • 55992 Bibbo, C., Patel, D. V., Gehrmann, R. M., and Lin, S. S. Chlorhexidine provides superior skin decontamination in foot and ankle surgery: a prospective randomized study. Clin Orthop.Relat Res 2005;438:204-208.
  • 55993 Chang, F. Y., Chang, M. C., Wang, S. T., Yu, W. K., Liu, C. L., and Chen, T. H. Can povidone-iodine solution be used safely in a spinal surgery? Eur Spine J 2006;15(6):1005-1014.
  • 55994 Ellenhorn, J. D., Smith, D. D., Schwarz, R. E., Kawachi, M. H., Wilson, T. G., McGonigle, K. F., Wagman, L. D., and Paz, I. B. Paint-only is equivalent to scrub-and-paint in preoperative preparation of abdominal surgery sites. J Am Coll.Surg 2005;201(5):737-741.
  • 55995 Lye, W. C., Lee, E. J., and Tan, C. C. Prophylactic antibiotics in the insertion of Tenckhoff catheters. Scand J Urol Nephrol. 1992;26(2):177-180.
  • 55996 Zimmermann, M. B., Connolly, K., Bozo, M., Bridson, J., Rohner, F., and Grimci, L. Iodine supplementation improves cognition in iodine-deficient schoolchildren in Albania: a randomized, controlled, double-blind study. Am J Clin Nutr 2006;83(1):108-114.
  • 55997 Leslie, K. S., Dootson, G., and Sterling, J. C. Topical salicylic acid gel as a treatment for molluscum contagiosum in children. J Dermatolog.Treat 2005;16(5-6):336-340.
  • 55998 Del Peloso, Ribeiro E., Bittencourt, S., Ambrosano, G. M., Nociti, F. H., Jr., Sallum, E. A., Sallum, A. W., and Casati, M. Z. Povidone-iodine used as an adjunct to non-surgical treatment of furcation involvements. J Periodontol. 2006;77(2):211-217.
  • 55999 Hajipour, L., Longstaff, L., Cleeve, V., Brewster, N., Bint, D., and Henman, P. Hand washing rituals in trauma theatre: clean or dirty? Ann R.Coll.Surg Engl. 2006;88(1):13-15.
  • 56000 Harihara, Y., Konishi, T., Kobayashi, H., Furushima, K., Ito, K., Noie, T., Nara, S., and Tanimura, K. Effects of applying povidone-iodine just before skin closure. Dermatology 2006;212 Suppl 1:53-57.
  • 56001 Daroczy, J. Quality control in chronic wound management: the role of local povidone-iodine (Betadine) therapy. Dermatology 2006;212 Suppl 1:82-87.
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  • 56003 Seguin, P., Tanguy, M., Laviolle, B., Tirel, O., and Malledant, Y. Effect of oropharyngeal decontamination by povidone-iodine on ventilator-associated pneumonia in patients with head trauma. Crit Care Med 2006;34(5):1514-1519.
  • 56004 Richter, R., Below, H., Kadow, I., Kramer, A., Muller, C., and Fusch, C. Effect of topical 1.25% povidone-iodine eyedrops used for prophylaxis of ophthalmia neonatorum on renal iodine excretion and thyroid-stimulating hormone level. J Pediatr 2006;148(3):401-403.
  • 56005 Nelson, E. A., O'Meara, S., Golder, S., Dalton, J., Craig, D., and Iglesias, C. Systematic review of antimicrobial treatments for diabetic foot ulcers. Diabet.Med 2006;23(4):348-359.
  • 56006 Ibrahim, M., Sinn, J., and McGuire, W. Iodine supplementation for the prevention of mortality and adverse neurodevelopmental outcomes in preterm infants. Cochrane.Database.Syst.Rev 2006;(2):CD005253.
  • 56007 Forabosco, A., Spinato, S., Grandi, T., and Prini, M. A comparative study between different techniques in non-surgical periodontal treatment. Minerva Stomatol. 2006;55(5):289-296.
  • 56009 Ho, K. M. and Litton, E. Use of chlorhexidine-impregnated dressing to prevent vascular and epidural catheter colonization and infection: a meta-analysis. J Antimicrob.Chemother. 2006;58(2):281-287.
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  • 56012 Short, K. A., Fuller, L. C., and Higgins, E. M. Double-blind, randomized, placebo-controlled trial of the use of topical 10% potassium hydroxide solution in the treatment of molluscum contagiosum. Pediatr Dermatol. 2006;23(3):279-281.
  • 56013 Teng, W., Shan, Z., Teng, X., Guan, H., Li, Y., Teng, D., Jin, Y., Yu, X., Fan, C., Chong, W., Yang, F., Dai, H., Yu, Y., Li, J., Chen, Y., Zhao, D., Shi, X., Hu, F., Mao, J., Gu, X., Yang, R., Tong, Y., Wang, W., Gao, T., and Li, C. Effect of iodine intake on thyroid diseases in China. N Engl.J Med 6-29-2006;354(26):2783-2793.
  • 56014 Vogt, P. M., Reimer, K., Hauser, J., Rossbach, O., Steinau, H. U., Bosse, B., Muller, S., Schmidt, T., and Fleischer, W. PVP-iodine in hydrosomes and hydrogel--a novel concept in wound therapy leads to enhanced epithelialization and reduced loss of skin grafts. Burns 2006;32(6):698-705.
  • 56015 Noparat, W., Siripanichakorn, K., Tribuddharat, C., and Danchaivijitr, S. Persistence of antimicrobial effect of antiseptics in surgical hand hygiene regimens. J Med Assoc.Thai. 2005;88 Suppl 10:S177-S182.
  • 56017 Leonhardt, A., Bergstrom, C., Krok, L., and Cardaropoli, G. Healing following ultrasonic debridement and PVP-iodine in individuals with severe chronic periodontal disease: a randomized, controlled clinical study. Acta Odontol.Scand 2006;64(5):262-266.
  • 56018 Gupta, C., Czubatyj, A. M., Briski, L. E., and Malani, A. K. Comparison of two alcohol-based surgical scrub solutions with an iodine-based scrub brush for presurgical antiseptic effectiveness in a community hospital. J Hosp.Infect. 2007;65(1):65-71.
  • 56019 Vuerstaek, J. D., Vainas, T., Wuite, J., Nelemans, P., Neumann, M. H., and Veraart, J. C. State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressings. J Vasc Surg 2006;44(5):1029-1037.
  • 56020 Hauser, J., Rossbach, O., Vogt, P. M., Reimer, K., Bosse, B., Fleischer, W., and Steinau, H. U. [Efficacy of treatment with Repithel and Jelonet in comparison to treatment with Jelonet alone - a randomized clinical trial in patients receiving meshed skin grafts]. Zentralbl.Chir 2006;131(4):315-321.
  • 56021 Lee, O. K. and Johnston, L. A systematic review for effective management of central venous catheters and catheter sites in acute care paediatric patients. Worldviews.Evid.Based.Nurs. 2005;2(1):4-13.
  • 56022 Hanna, D., Hatami, A., Powell, J., Marcoux, D., Maari, C., Savard, P., Thibeault, H., and McCuaig, C. A prospective randomized trial comparing the efficacy and adverse effects of four recognized treatments of molluscum contagiosum in children. Pediatr Dermatol. 2006;23(6):574-579.
  • 56023 Potting, C. M., Uitterhoeve, R., Op Reimer, W. S., and Van, Achterberg T. The effectiveness of commonly used mouthwashes for the prevention of chemotherapy-induced oral mucositis: a systematic review. Eur J Cancer Care (Engl.) 2006;15(5):431-439.
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  • 56026 Brussieux, J., Boisivon, A., Theron, H. P., Faidherbe, C., Machado, N., and Michelon, B. [Prevention of neonatal conjunctivitis. A comparative clinical and bacteriologic study of 2 eyedrops: silver nitrate and oxytetracycline chlorhydrate]. Ann Pediatr (Paris) 1991;38(9):637-641.
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  • 56028 Queck, M., Weiss, E., and Berle, P. [Local administration of metronidazole before hysterectomy--effect on infectious morbidity. A prospective study]. Geburtshilfe Frauenheilkd. 1991;51(10):839-842.
  • 56029 Levin, A., Mason, A. J., Jindal, K. K., Fong, I. W., and Goldstein, M. B. Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine. Kidney Int 1991;40(5):934-938.
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  • 56032 Seidel, C., Richter, U. G., Buhler, S., and Hornstein, O. P. Drug therapy of diabetic neuropathic foot ulcers: transvenous retrograde perfusion versus systemic regimen. Vasa 1991;20(4):388-393.
  • 56033 Swartz, R., Messana, J., Starmann, B., Weber, M., and Reynolds, J. Preventing Staphylococcus aureus infection during chronic peritoneal dialysis. J Am Soc Nephrol. 1991;2(6):1085-1091.
  • 56035 Webster, J. and Alghamdi, A. A. Use of plastic adhesive drapes during surgery for preventing surgical site infection. Cochrane.Database.Syst.Rev 2007;(4):CD006353.
  • 56036 Ramirez-Ortiz, M. A., Rodriguez-Almaraz, M., Ochoa-Diazlopez, H., Diaz-Prieto, P., and Rodriguez-Suarez, R. S. Randomised equivalency trial comparing 2.5% povidone-iodine eye drops and ophthalmic chloramphenicol for preventing neonatal conjunctivitis in a trachoma endemic area in southern Mexico. Br J Ophthalmol. 2007;91(11):1430-1434.
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