Iodine deficiency is an important clinical and public health problem. Its prevention begins with an adequate intake of iodine during pregnancy. International agencies recommend at least 200 mg iodine per d for pregnant women. We assessed whether iodine concentrations in the amniotic fluid of healthy pregnant women are independent of iodine intake. This cross-sectional, non-interventional study included 365 consecutive women who underwent amniocentesis to determine the fetal karyotype. The amniocentesis was performed with abdominal antisepsis using chlorhexidine. The iodine concentration was measured in urine and amniotic fluid. The study variables were the intake of iodized salt and multivitamin supplements or the prescription of a KI supplement. The mean level of urinary iodine was 139·0 (SD 94·5) mg/l and of amniotic fluid 15·81 (SD 7·09) mg/l. The women who consumed iodized salt and those who took a KI supplement had significantly higher levels of urinary iodine than those who did not (P¼ 0·01 and P¼0·004, respectively). The urinary iodine levels were not significantly different in the women who took a multivitamin supplement compared with those who did not take this supplement, independently of iodine concentration or multivitamin supplement. The concentrations of iodine in the amniotic fluid were similar, independent of the dietary iodine intake. Urine and amniotic fluid iodine concentrations were weakly correlated, although the amniotic fluid values were no higher in those women taking a KI supplement. KI prescription at recommended doses increases the iodine levels in the mother without influencing the iodine levels in the amniotic fluid. Iodine: Amniotic fluid: PregnancyAlthough marked physiological differences exist between the maternal and fetal thyroids, both systems interact through the placenta and the amniotic fluid, modulating the transfer of iodine and small but biologically important amounts of thyroid hormones from the mother to the fetus (1) . Prior to the end of the first trimester, when the fetal thyroid gland and the pituitary-thyroid axis become functional, the thyroid hormones required by the fetus are all obtained from the maternal circulation (2) .The volume and content of amniotic fluid is the result of a balance between the urine and the fetal pulmonary fluids, the amount of fluid that is reabsorbed or swallowed by the fetus (3) and transfer of water and solutes across the fetal membranes.Animal studies have demonstrated a rapid exchange between the mother and fetus and between the fetus and the amniotic fluid, suggesting that the amniotic fluid could act as an iodine reservoir for the fetus (4) . Etling et al. (5) found high levels of iodine in the amniotic fluid of women who had undergone urographic examinations with iodized contrast materials or who had been exposed to iodized agents vaginally. However, few studies have investigated the iodine concentration in the amniotic fluid of human subjects and these only examined the influence of the overload of high iodine concentrations. ...

Objetivo: Comparar la eficacia de la prevención no farmacológica estándar (PnFE) versus la prevención no farmacológica reforzada (PnFR), consistente en prevención no farmacológica estándar más Terapia Ocupacional (TO) precoz e intensiva, en la incidencia del delirium en adultos mayores (AM) ingresados a unidad de pacientes críticos (UPC). Diseño: Ensayo clínico randomizado, en UPC del Hospital Clínico de la Universidad de Chile (HCUCH). Sujetos: 70 pacientes de edad igual o superior a 60 años, ingresados al HCUCH entre abril y octubre del 2011, con necesidad de ingreso a UPC para monitorización, hospitalización por enfermedad aguda/crónica descompensada, con consentimiento del paciente o familiar y sin presencia de delirium al ingreso ni deterioro cognitivo previo al estudio. Materiales y Métodos: PnFE (grupo control) consiste en: reorientación, movilización precoz, corrección de déficit sensoriales, manejo ambiental, protocolo de sueño y reducción de fármacos anticolinérgicos, versus PnFR (grupo experimental), que considera las siguientes áreas de intervención de TO: estimulación polisensorial, posicionamiento, estimulación cognitiva, entrenamiento en actividades de la vida diaria básica, estimulación motora de extremidades superiores y participación familiar; durante 5 días, dos veces al día. Se evaluó la presencia del delirium, con el CAM dos veces al día durante 5 días, y la severidad de éste con DRS; previo al alta se evaluó, independencia funcional con FIM, estado cognitivo con MMSE y fuerza de garra con dinamómetro de Jamar. Resultados: La PnFR de TO se asocia a menor incidencia de delirium, afectando al 16,1% del grupo con prevención no farmacológica estándar versus un 3,1% del con prevención no farmacológica reforzada, así como a menos días de hospitalización (20,6 días versus 10,4 p=.009). La independencia funcional al alta se mantiene en aspectos cognitivos (32,5 versus 32,9) mientras que en aspectos motores aumenta significativamente (46,5 versus 58,3l, P=.03). Conclusión: La intervención precoz e intensiva de TO es efectiva en la prevención del delirium en AM hospitalizados, reduce su estadía y aumenta niveles de independencia funcional motora al alta.

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