Thyroid Federation International - ThyroWorld -1.1 ThyroMobil

Welcome Brazil

From ThyroWorld, Volume 5, No. 1, Spring 2002

"INSTITUTO da TIROIDE" Thanks to the efforts of Dr. Geraldo Medeiros-Neto, TFI has a new member organization, the "Instituto da Tiroide" in Sao Paulo, Brazil.

Dr. Medeiros-Neto is a world-renowned thyroid specialist who has wanted for some time to develop a thyroid organization for patients in Brazil. Unfortunately, the creation of a not-for- profit group is very complex and costly in Sao Paulo. Fortunately, however, Dr. Medeiros- Neto had a patient whom he had treated for a thyroid condition many years ago. This friend gave Dr. Medeiros-Neto the help he needed to create the organization. A Board of nine members, consisting of seven physicians, one lawyer, and the donor met to start the organization. They wrote the bylaws, and registered as a tax-exempt not-for-profit organization.

Early Success

In 1990, a law was passed in Brazil stating that every infant has the right to be tested for congenital disorders. In 1999, the government added congenital hypothyroidism to the screening list. The Instituto da Tiroide surveyed the entire population of Brazil and found that two-thirds of newborn babies are already being screened for congenital hypothyroidism. They are now advocating appropriate screening for the rest of these children.

ThyroMobil: Testing Iodine Deficiency

A second project taken on by the young association involved national testing to see if iodine deficiency was still present in Brazil. For this, they asked Merck KGaA in Darmstatdt, Germany to provide them with the services of a ThyroMobil van. This remarkable vehicle travels the country offering testing for urinary iodine concentration, iodine content of table salt and thyroid ultrasounds. The result: less than 1.8% of the population is currently iodine deficient. Interestingly, that is better than in the United States of America, where it is now estimated that 25% of pregnant women have borderline iodine deficiency.

Their next project was to find out whether adequate amounts of iodine were being added to salt. The answer: iodination was satisfactory.

Free Thyroid Evaluations

Finally Dr. Valeria Guimaraes, member of the Institute's Board of Directors, decided to find out what percent of the population have thyroid nodules. She enlisted the help of medical students, who put up signs in gas stations and other businesses offering free thyroid evaluations. The students would evaluate anyone who agreed to a neck examination. The idea was supported by the press and television, and with great enthusiasm the study was completed. The finding was that 14% of adults in Brazil have thyroid nodules. These individuals are now offered help to be sure that they have appropriate evaluation and treatment.

What's Ahead?

The Instituto da Tiroide is now looking at the question of thyroid deficiency during and after pregnancy. Under Dr. Victor Siaulys, they are proposing that obstetricians measure TSH levels during pregnancy and at three, six, and twelve months postpartum. They also propose that thyroid auto-antibodies could be assayed periodically after delivery to check for post-partum thyroid dysfunction. They anticipate good collaboration with obstetricians throughout Brazil.

We welcome Dr. Medeiros-Neto, his colleagues, and the Instituto da Tiroide as members in the Thyroid Federation International. We look forward to their joining us in Sweden and to hearing more about their organization, their projects, and their plans for the future.

Lawrence C. Wood, MD