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      Severe Hypothyroidism From Iodine Deficiency Associated With Parenteral Nutrition

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      Journal of Parenteral and Enteral Nutrition
      SAGE Publications

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          A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products.

          The parenteral multivitamin preparations that are commercially available in the United States (U.S.) meet the requirements for most patients who receive parenteral nutrition (PN). However, a separate parenteral vitamin D preparation (cholecalciferol or ergocalciferol) should be made available for treatment of patients with vitamin D deficiency unresponsive to oral vitamin D supplementation. Carnitine is commercially available and should be routinely added to neonatal PN formulations. Choline should also be routinely added to adult and pediatric PN formulations; however, a commercially available parenteral product needs to be developed. The parenteral multi-trace element (TE) preparations that are commercially available in the U.S. require significant modifications. Single-entity trace element products can be used to meet individual patient needs when the multiple-element products are inappropriate (see Summary/A.S.P.E.N. Recommendations section for details of these proposed modifications).
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            1. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR).

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              Iodine status of the U.S. population, National Health and Nutrition Examination Survey 2003-2004.

              Since 1971, the general U.S. population has been monitored for dietary iodine sufficiency by urinary iodine (UI) measurements through the National Health and Nutrition Examination Survey (NHANES). This report presents the UI levels for the population participating in NHANES 2003-2004. It is the third assessment of the U.S. population since NHANES III (1988-1994), when the median UI level was observed to decrease from NHANES I (1971-1974). In 2003-2004, a stratified, multistage, probability sample of approximately 5000 participants per year were selected to participate in NHANES Household interviews, and specimen collection were performed. UI level was measured by inductively coupled plasma mass spectrometry on a random subsample of 2526 participants aged 6 years and older. The median UI level for the general U.S. population in 2003-2004 was 160 microg/L (95% confidence interval [CI] 146-172), and 11.3 +/- 1.8% of the population had a UI level below 50 microg/L. Children had a higher UI level than adolescents and adults. Among all (pregnant and nonpregnant) women of reproductive age, the median UI level was 139 microg/L (95% CI 117-156), 15.1 +/- 3.2% women had a UI level <50 microg/L, and Non-Hispanic blacks in this group had a lower UI level than other racial/ethnic groups. These findings affirm the stabilization of the UI level and the adequate iodine nutrition in the general U.S. population since 2000. Future surveys designed to achieve UI levels representative of pregnant women can improve the estimate of iodine sufficiency in this population subgroup. Continued monitoring of the population for iodine sufficiency is warranted because of groups at risk for iodine deficiency disorders.
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                Author and article information

                Journal
                Journal of Parenteral and Enteral Nutrition
                JPEN J Parenter Enteral Nutr
                SAGE Publications
                0148-6071
                1941-2444
                October 07 2016
                July 11 2016
                : 40
                : 8
                : 1191-1193
                Article
                10.1177/0148607115584002
                7e1ed380-e0c8-4850-ad69-2082c8f81e99
                © 2016
                History

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