text:
Potassium iodide
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Potassium iodide
Clinical data
Trade names
iOSAT, SSKI, ThyroSafe, ThyroShield, others
AHFS/Drugs.com
Monograph
Pregnancy
category
US: D (Evidence of risk)
ATC code
R05CA02 (WHO) S01XA04 (WHO), V03AB21 (WHO)
Legal status
Legal status
US: OTC
Identifiers
IUPAC name[show]
Potassium iodide
CAS Number
7681-11-0 Y
PubChem CID
4875
DrugBank
DB06715
ChemSpider
4709
UNII
1C4QK22F9J
KEGG
D01016
ChEBI
CHEBI:8346
ChEMBL
CHEMBL1141
ECHA InfoCard
100.028.782
Chemical and physical data
Formula
KI
Molar mass
166.0028
3D model (JSmol)
Interactive image
Melting point
681 °C (1,258 °F)
Boiling point
1,330 °C (2,430 °F)
Solubility in water
1280 mg/mL (0 °C (32 °F))
1400 mg/mL (20 °C (68 °F))
1760 mg/mL (60 °C (140 °F))
2060 mg/mL (100 °C (212 °F))
SMILES[show]
[K+].[I-]
InChI[show]
InChI=1S/HI.K/h1H;/q;+1/p-1 Y
Key:NLKNQRATVPKPDG-UHFFFAOYSA-M
Potassium iodide is a chemical compound, medication, and dietary supplement.[1][2] As a medication it is used to treat hyperthyroidism, in radiation emergencies, and to protect the thyroid gland when certain types of radiopharmaceuticals are used.[3] In the developing world it is also used to treat skin sporotrichosis and phycomycosis.[3][4] As a supplement it is used in those who have low intake of iodine in the diet.[2] It is given by mouth.[3]
Common side effects include vomiting, diarrhea, abdominal pain, rash, and swelling of the salivary glands.[3] Other side effects include allergic reactions, headache, goitre, and depression.[4] While use during pregnancy may harm the baby, its use is still recommended in radiation emergencies.[3] Potassium iodide has the chemical formula KI.[5] Commercially it is made by mixing potassium hydroxide with iodine.[6]
Potassium iodide has been used medically since at least 1820.[7] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[8] Potassium iodide is available as a generic medication and over the counter.[9] In the United States a course of treatment is less than 25 USD.[9] Potassium iodide is also used for the iodization of salt.[2]
Contents
[hide]
1 Medical uses
1.1 Dietary supplement
1.2 Thyroid protection
1.3 Nuclear accidents
2 Side effects
3 Industrial uses
4 Chemistry
4.1 Inorganic chemistry
4.2 Organic chemistry
5 History
5.1 Chernobyl
5.2 Nagasaki
5.3 Nuclear weapons testing
5.4 Fukushima
6 Formulations
7 See also
8 References
9 External links
Medical uses[edit]
Dietary supplement[edit]
The uses of KI include as a nutritional supplement in animal feeds and also the human diet. For the latter, it is the most common additive used to "iodize" table salt (a public health measure to prevent iodine deficiency in populations that get little seafood). The oxidation of iodide causes slow loss of iodine content from iodised salts that are exposed to excess air. The alkali metal iodide salt, over time and exposure to excess oxygen and carbon dioxide, slowly oxidizes to metal carbonate and elemental iodine, which then evaporates.[10] Potassium iodate (KIO3) is used to add iodine to some salts so that the iodine is not lost by oxidation. Dextrose or sodium thiosulfate are often added to iodized table salt to stabilize potassium iodide thus reducing loss of the volatile chemical.[11]
Thyroid protection[edit]
Pheochromocytoma seen as dark sphere in center of the body. Image is by MIBG scintigraphy with radiation from radioiodine in the MIBG. However, note unwanted uptake of radioiodine from the pharmaceutical by the thyroid gland in the neck, in both images (front and back) of the same patient. Radioactivity is also seen in the bladder.
Thyroid iodine uptake blockade with potassium iodide is used in nuclear medicine scintigraphy and therapy with some radioiodinated compounds that are not targeted to the thyroid, such as iobenguane (MIBG), which is used to image or treat neural tissue tumors, or iodinated fibrinogen, which is used in fibrinogen scans to investigate clotting. These compounds contain iodine, but not in the iodide form. However, since they may be ultimately metabolized or break down to radioactive iodide, it is common to administer non-radioactive potassium iodide to ensure that iodide from these radiopharmaceuticals is not sequestered by the normal affinity of the thyroid for iodide.
U.S. Food and Drug Administration-approved dosing of potassium iodide for this purpose with iobenguane, is as follows (per 24 hours): infants less than 1 month old, 16 mg; children 1 month to 3 years, 32 mg; children 3 years to 18 years, 65 mg; adults 130 mg.[12] However, some sources recommend alternative dosing regimens.[13]
Not all sources are in agreement on the necessary duration of thyroid blockade, although agreement appears to have been reached about the necessity of blockade for both scintigraphic and therapeutic applications of iobenguane. Commercially available iobenguane is labeled with iodine-123, and product labeling recommends administration of potassium iodide 1 hour prior to administration of the radiopharmaceutical for all age groups,[14] while the European Association of Nuclear Medicine recommends (for iobenguane labeled with either isotope), that potassium iodide administration begin one day prior to radiopharmaceutical administration, and continue until the day following the injection, with the exception of new-borns, who do not require potassium iodide doses following radiopharmaceutical injection.[13][15]
Product labeling for diagnostic iodine-131 iobenguane recommends potassium iodide administration one day before injection and continuing 5 to 7 days following administration, in keeping with the much longer half-life of this isotope and its greater danger to the thyroid.[16] Iodine-131 iobenguane used for therapeutic purposes requires a different pre-medication duration, beginning 24–48 hours prior to iobenguane injection and continuing 10–15 days following injection.[17]
Nuclear accidents[edit]
In 1982, the U.S. Food and Drug Administration approved potassium iodide to protect thyroid glands from radioactive iodine involving accidents or fission emergencies.[citation needed] In an accidental event or attack on a nuclear power plant, or in nuclear bomb fallout, volatile fission product radionuclides may be released. Of these products, 131
I
is one of the most common and is particularly dangerous to the thyroid gland because it may lead to thyroid cancer.[citation needed] By saturating the body with a source of stable iodide prior to exposure, inhaled or ingested 131
I
tends to be excreted, which prevents radioiodine uptake by the thyroid. According to one 2000 study "KI administered up to 48 h before 131
I
exposure can almost completely block thyroid uptake and therefore greatly reduce the thyroid absorbed dose. However, KI administration 96 h or more before 131
I
exposure has no significant protective effect. In contrast, KI administration after exposure to radioiodine induces a smaller and rapidly decreasing blockade effect."[18] For optimal prevention, KI must be dosed daily until a risk of significant exposure to radioiodine by either inhalation or ingestion no longer exists.
Emergency 130 milligrams potassium iodide doses provide 100 mg iodide (the other 30 mg is the potassium in the compound), which is roughly 700 times larger than the normal nutritional need (see recommended dietary allowance) for iodine, which is 150 micrograms (0.15 mg) of iodine (as iodide) per day for an adult. The typical tablet actually weighs 160 mg. 130 mg of which is potassium iodide, and 30 mg being excipients, such as binding agents.
Potassium iodide cannot protect against any other mechanisms of radiation poisoning, nor can it provide any degree of protection against dirty bombs that produce radionuclides other than those of iodine.
WHO Recommended Dosage for Radiological Emergencies involving radioactive iodine[19]
Age
KI in mg per day
Over 12 years old 130
3 – 12 years old 65
1 – 36 months old 32
< 1 month old 16
The potassium iodide in iodized salt is insufficient for this use.[20] A likely lethal dose of salt (more than a kilogram[21]) would be needed to equal the potassium iodide in one tablet.[22]
The World Health Organization does not recommend KI prophylaxis for adults over 40 years, unless the radiation dose from inhaled radioiodine is expected to threaten thyroid function, because the KI side effects increase with age and may exceed the KI protective effects; "...unless doses to the thyroid from inhalation rise to levels threatening thyroid function, that is of the order of about 5 Gy. Such radiation doses will not occur far away from an accident site."[19]
The U.S. Department of Health and Human Services restated these two years later as "The downward KI (potassium iodide) dose adjustment by age group, based on body size considerations, adheres to the principle of minimum effective dose. The recommended standard (daily) dose of KI for all school-age children is the same (65 mg). However, adolescents approaching adult size (i.e., >70 kg [154 lbs]) should receive the full adult dose (130 mg) for maximal block of thyroid radioiodine uptake. Neonates ideally should receive the lowest dose (16 mg) of KI."[23]
SSKI (i.e., the "saturated solution of KI" rather than tablets) may be used in radioiodine-contamination emergencies (i.e., nuclear accidents) to "block" the thyroid's uptake of radioiodine, at a dose of two drops of SSKI per day for an adult. This is not the same as blocking the thyroid's release of thyroid hormone, for which the adult dose is different (and is actually higher by a factor of 7 or 8), and for which KI anti-radiation pills (not a common medical treatment form of KI) are not usually available in pharmacies, or normally used in hospitals, or by physicians. Although the two forms of potassium iodide are completely interchangeable, normally in practice the SSKI solution, which is the historical medical form of high dose iodine, is generally used for all medical purposes save for radioiodine prophylaxis. For protection of the thyroid against radioiodine (iodine-131) contamination, the convenient standard 130 mg KI pill is used, if available. As noted, the equivalent two drops of SSKI (equaling the dose of one KI pill) may be used for this purpose, if the pills are not available.
Side effects[edit]
There is reason for caution with prescribing the ingestion of high doses of potassium iodide and iodate, as their unnecessary use can cause conditions such as the Jod-Basedow phenomena, trigger and/or worsen hyperthyroidism and hypothyroidism, and then cause temporary or even permanent thyroid conditions. It can also cause sialadenitis (an inflammation of the salivary gland), gastrointestinal disturbances, and rashes. Potassium iodide is also not recommended for people with dermatitis herpetiformis and hypocomplementemic vasculitis – conditions that are linked to a risk of iodine sensitivity.[24]
There have been some reports of potassium iodide treatment causing swelling of the parotid gland (one of the three glands which secrete saliva), due to its stimulatory effects on saliva production.[25]
A saturated solution of KI (SSKI) is typically given orally in adult doses several times a day (5 drops of SSKI assumed to be 1⁄3 mL) for thyroid blockade (to prevent the thyroid from excreting thyroid hormone) and occasionally this dose is also used, when iodide is used as an expectorant (the total dose is about one gram KI per day for an adult). The anti-radioiodine doses used for 131
I
uptake blockade are lower, and range downward from 100 mg a day for an adult, to less than this for children (see table). All of these doses should be compared with the far lower dose of iodine needed in normal nutrition, which is only 150 μg per day (150 micrograms, not milligrams).
At maximal doses, and sometimes at much lower doses, side effects of iodide used for medical reasons, in doses of 1000 times the normal nutritional need, may include: acne, loss of appetite, or upset stomach (especially during the first several days, as the body adjusts to the medication). More severe side effects which require notification of a physician are: fever, weakness, unusual tiredness, swelling in the neck or throat, mouth sores, skin rash, nausea, vomiting, stomach pains, irregular heartbeat, numbness or tingling of the hands or feet, or a metallic taste in the mouth.[26]
The use of a particular 'Iodine tablet' used in portable water purification has also been determined as somewhat effective at reducing radioiodine uptake. In a small study on human subjects, who for each of their 90-day trial, ingested four 20 milligram tetraglycine hydroperiodide(TGHP) water tablets, with each tablet releasing 8 milligrams (ppm) of free titratable iodine;[27] it was found that the biological uptake of radioactive iodine in these human subjects dropped to, and remained at, a value of less than 2% the radioiodine uptake rate of that observed in control subjects who went fully exposed to radioiodine without treatment.[28]
In the event of a radioiodine release the ingestion of prophylaxis potassium iodide, if available, or even iodate, would rightly take precedence over perchlorate administration, and would be the first line of defence in protecting the population from a radioiodine release. However, in the event of a radioiodine release too massive and widespread to be controlled by the limited stock of iodide and iodate prophylaxis drugs, then the addition of perchlorate ions to the water supply, or distribution of perchlorate tablets would serve as a cheap, efficacious, second line of defense against carcinogenic radioiodine bioaccumulation.
The ingestion of goitrogen drugs is, much like potassium iodide also not without its dangers, such as hypothyroidism. In all these cases however, despite the risks, the prophylaxis benefits of intervention with iodide, iodate or perchlorate outweigh the serious cancer risk from radioiodine bioaccumulation in regions where radioiodine has sufficiently contaminated the environment.
Potassium iodide in its raw form is a mild irritant and should be handled with gloves. Chronic overexposure can have adverse effects on the thyroid. Potassium iodide is a possible teratogen.[citation needed]
Industrial uses[edit]
KI is used with silver nitrate to make silver iodide (AgI), an important chemical in film photography. KI is a component in some disinfectants and hair treatment chemicals. KI is also used as a fluorescence quenching agent in biomedical research, an application that takes advantage of collisional quenching of fluorescent substances by the iodide ion. However, for several fluorophores addition of KI in µM-mM concentrations results in increase of fluorescence intensity, and iodide acts as fluorescence enhancer.[29]
Potassium iodide is a component in the electrolyte of dye sensitised solar cells (DSSC) along with iodine.
Potassium iodide finds its most important applications in organic synthesis mainly in the preparation of aryl iodides in the Sandmeyer reaction, starting from aryl amines. Aryl iodides are in turn used to attach aryl groups to other organics by nucleophilic substitution, with iodide ion as the leaving group.
Chemistry[edit]
Potassium iodide is ionic, K+I−. It crystallises in the sodium chloride structure. It is produced industrially by treating KOH with iodine.[30]
It is a white salt, which is the most commercially significant iodide compound, with approximately 37,000 tons produced in 1985. It absorbs water less readily than sodium iodide, making it easier to work with.
Aged and impure samples are yellow because of the slow oxidation of the salt to potassium carbonate and elemental iodine.[30]
4 KI + 2 CO2 + O2 → 2 K2CO3 + 2 I2
Inorganic chemistry[edit]
Since the iodide ion is a mild reducing agent, I− is easily oxidised to I2 by powerful oxidising agents such as chlorine:
2 KI(aq) + Cl2(aq) → 2 KCl(aq) + I2(aq)
This reaction is employed in the isolation of iodine from natural sources. Air will oxidize iodide, as evidenced by the observation of a purple extract when aged samples of KI are rinsed with dichloromethane. As formed under acidic conditions, hydriodic acid (HI) is a stronger reducing agent.[31][32][33]
Like other iodide salts, KI forms I3− when combined with elemental iodine.
KI(aq) + I2(s) → KI3(aq)
Unlike I2, I3− salts can be highly water-soluble. Through this reaction, iodine is used in redox titrations. Aqueous KI3, "Lugol's solution", is used as a disinfectant and as an etchant for gold surfaces.
Potassium iodide and silver nitrate are used to make silver(I) iodide, which is used for high speed photographic film and for cloud-seeding:
KI(aq) + AgNO3(aq) → AgI(s) + KNO3(aq)
Organic chemistry[edit]
KI serves as a source of iodide in organic synthesis. A useful application is in the preparation of aryl iodides from arenediazonium salts.[34][35] For example:
KI, acting as a source of iodide, may also act as a nucleophilic catalyst for the alkylation of alkyl chlorides, bromides, or mesylates.
History[edit]
Potassium iodide has been used medically since at least 1820.[7] Some of the earliest uses included for syphilis.[7]
Chernobyl[edit]
Potassium iodide's (KI) value as a radiation protective (thyroid blocking) agent was demonstrated following the Chernobyl nuclear reactor disaster in April, 1986, a saturated solution of potassium iodide (SSKI) was administered to 10.5 million children and 7 million adults in Poland[23][36] as a preventative measure against accumulation of radioactive 131
I
in the thyroid gland.
Reports differ concerning whether people in the areas immediately surrounding Chernobyl itself were given the supplement.,[37][15] however the US Nuclear Regulatory Commission (NRC) reported, "thousands of measurements of I-131 (radioactive iodine) activity...suggest that the observed levels were lower than would have been expected had this prophylactic measure not been taken. The use of KI...was credited with permissible iodine content in 97% of the evacuees tested."[15]
With the passage of time, people living in irradiated areas where KI was not available have developed thyroid cancer at epidemic levels, which is why the US Food and Drug Administration (FDA) reported "The data clearly demonstrate the risks of thyroid radiation... KI can be used [to] provide safe and effective protection against thyroid cancer caused by irradiation."[38]
Chernobyl also demonstrated that the need to protect the thyroid from radiation was greater than expected. Within ten years of the accident, it became clear that thyroid damage caused by released radioactive iodine was virtually the only adverse health effect that could be measured. As reported by the NRC, studies after the accident showed that "As of 1996, except for thyroid cancer, there has been no confirmed increase in the rates of other cancers, including leukemia, among the... public, that have been attributed to releases from the accident."[39]
But equally important to the question of KI is the fact that radioactivity releases are not "local" events. Researchers at the World Health Organization accurately located and counted the cancer victims from Chernobyl and were startled to find that "the increase in incidence [of thyroid cancer] has been documented up to 500 km from the accident site... significant doses from radioactive iodine can occur hundreds of kilometers from the site, beyond emergency planning zones."[19] Consequently, far more people than anticipated were affected by the radiation, which caused the United Nations to report in 2002 that "The number of people with thyroid cancer... has exceeded expectations. Over 11,000 cases have already been reported."[40]
Nagasaki[edit]
These findings were consistent with studies of the effects of previous radioactivity releases. In 1945, millions of Japanese were exposed to radiation from nuclear weapons, and the effects can still be measured. Today, nearly half (44.8%) the survivors of Nagasaki studied have identifiable thyroid disease, with the American Medical Association (AMA) reporting "it is remarkable that a biological effect from a single brief environmental exposure nearly 60 years in the past is still present and can be detected."[41]
Nuclear weapons testing[edit]
The development of thyroid cancer among residents in the North Pacific from radioactive fallout following the United States' nuclear weapons testing in the 1950s (on islands nearly 200 miles downwind of the tests) were instrumental in the 1978 decision by the FDA to issue a request for the availability of KI for thyroid protection in the event of a release from a commercial nuclear power plant or weapons-related nuclear incident. Noting that KI's effectiveness was "virtually complete" and finding that iodine in the form of KI was substantially superior to other forms including iodate (KIO3) in terms of safety, effectiveness, lack of side effects, and speed of onset, the FDA invited manufacturers to submit applications to produce and market KI.[42]
Fukushima[edit]
It was reported on March 16, 2011, that potassium iodide tablets were given preventatively to U.S. Naval air crew members flying within 70 nautical miles of the Fukushima Daiichi Nuclear Power Plant damaged in the earthquake (8.9/9.0 magnitude) and ensuing tsunami on March 11, 2011. The measures were seen as precautions, and the Pentagon said no U.S. forces have shown signs of radiation poisoning. By March 20, the US Navy instructed personnel coming within 100 miles of the reactor to take the pills.[43]
Formulations[edit]
Three companies (Anbex, Inc., Fleming Co, and Recipharm of Sweden) have met the strict FDA requirements for manufacturing and testing of KI, and they offer products (IOSAT, ThyroShield, and ThyroSafe,[44] respectively) which are available for purchase. In 2012, Fleming Co. sold all its product rights and manufacturing facility to other companies and no longer exists. ThyroShield is currently not in production. The Swedish manufacturing facility for Thyrosafe, a half-strength potassium iodide tablet for thyroid protection from radiation, was mentioned on the secret US 2008 Critical Foreign Dependencies Initiative leaked by Wikileaks in 2010.[45]
Tablets of potassium iodide are supplied for emergency purposes related to blockade of radioiodine uptake, a common form of radiation poisoning due to environmental contamination by the short-lived fission product 131
I
.[46] Potassium iodide may also be administered pharmaceutically for thyroid storm.
For reasons noted above, therapeutic drops of SSKI, or 130 mg tablets of KI as used for nuclear fission accidents, are not used as nutritional supplements, since an SSKI drop or nuclear-emergency tablet provides 300 to 700 times more iodine than the daily adult nutritional requirement. Dedicated nutritional iodide tablets containing 0.15 mg (150 micrograms (µg)) of iodide, from KI or from various other sources (such as kelp extract) are marketed as supplements, but they are not to be confused with the much higher pharmaceutical dose preparations.
Potassium iodide can be conveniently prepared as a saturated solution, abbreviated SSKI. This method of delivering potassium iodide does not require a method to weigh out the potassium iodide so it can be used in an emergency situation. KI crystals are simply added to water until no more KI will dissolve and instead sits at the bottom of the container. With pure water, the concentration of KI in the solution depends only on the temperature. Potassium iodide is highly soluble in water so SSKI is a concentrated source of KI. At 20 degrees Celsius the solubility of KI is 140-148 grams per 100 grams of water.[47] Because the volumes of KI and water are approximately additive, the resulting SSKI solution will contain about 1.00 gram (1000 mg) KI per milliliter (mL) of solution. This is 100% weight/volume (note units of mass concentration) of KI (one gram KI per mL solution), which is possible because SSKI is significantly more dense than pure water—about 1.67 g/mL.[48] Because KI is about 76.4% iodide by weight, SSKI contains about 764 mg iodide per mL. This concentration of iodide allows the calculation of the iodide dose per drop, if one knows the number of drops per milliliter. For SSKI, a solution more viscous than water, there are assumed to be 15 drops per mL; the iodide dose is therefore approximately 51 mg per drop. It is conventionally rounded to 50 mg per drop.
The term SSKI is also used, especially by pharmacists, to refer to a U.S.P. pre-prepared solution formula, made by adding KI to water to prepare a solution containing 1000 mg KI per mL solution (100% wt/volume KI solution), to closely approximate the concentration of SSKI made by saturation. This is essentially interchangeable with SSKI made by saturation, and also contains about 50 mg iodide per drop.
Saturated solutions of potassium iodide can be an emergency treatment for hyperthyroidism (so-called thyroid storm), as high amounts of iodide temporarily suppress secretion of thyroxine from the thyroid gland.[49] The dose typically begins with a loading dose, then 1⁄3 mL SSKI (5 drops or 250 mg iodine as iodide), three times per day.
Iodide solutions made from a few drops of SSKI added to drinks have also been used as expectorants to increase the water content of respiratory secretions and encourage effective coughing.[50]
SSKI has been proposed as a topical treatment for sporotrichosis, but no trials have been conducted to determine the efficacy or side effects of such treatment.[51]
Potassium iodide has been used for symptomatic treatment of erythema nodosum patients for persistent lesions whose cause remains unknown. It has been used in cases of erythema nodosum associated with Crohn's disease.[52]
Due to its high potassium content, SSKI is extremely bitter, and if possible it is administered in a sugar cube or small ball of bread. It may also be mixed into much larger volumes of juices.
Neither SSKI or KI tablets are used as nutritional supplements, since the nutritional requirement for iodine is only 150 micrograms (0.15 mg) of iodide per day. Thus, a drop of SSKI provides 50/0.15 = 333 times the daily iodine requirement, and a standard KI tablet provides twice this much.
See also[edit]
Elephant toothpaste
References[edit]
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Jump up ^ Nauman, Janusz; Wolff, Jan (1993). "Iodide prophylaxis in Poland after the chernobyl reactor accident: Benefits and risks". The American Journal of Medicine. 94 (5): 524–32. doi:10.1016/0002-9343(93)90089-8. PMID 8498398.
Jump up ^ Frot, Jacques. The Causes of the Chernobyl Event (doc) (Report). Berol Robinson (trans.). Environmentalists for Nuclear Energy. Archived from the original on 2012-04-08.
Jump up ^ US Food and Drug Administration, FDA Talk Paper: Guidance on Protection Against Thyroid Cancer in Case of a Nuclear Accident
Jump up ^ US Nuclear Regulatory Commission, Assessment of the Use of Potassium Iodide (KI) As a Public Protective Action During Severe Reactor Accidents Quoting Thyroid Cancer in Children of Belarus Following the Chernobyl Accident, NUREG-1633 "Archived copy" (PDF). Archived (PDF) from the original on 2009-05-14. Retrieved 2012-05-22. [page needed]
Jump up ^ United Nations: Office for the Coordination of Humanitarian Affairs (OCHA), Chernobyl, a Continuing Catastrophe, New York and Geneva, 2000[page needed]
Jump up ^ Boice, J. D. (2006). "Thyroid Disease 60 Years After Hiroshima and 20 Years After Chernobyl". JAMA. 295 (9): 1060–2. doi:10.1001/jama.295.9.1060. PMID 16507808.
Jump up ^ "Federal Register". US Federal Register. US Office of the Federal Register, National Archives and Records Administration. 43 (242). December 15, 1978.
Jump up ^ "Vegetables near stricken plant test high for radiation". CNN. 2011-03-22. Archived from the original on 2012-11-09.
Jump up ^ B. McFee, Robin; Jerrold B. Leikin (2007). Toxico-terrorism: emergency response and clinical approach to chemical, biological, and radiological agents, Volume 755. McGraw-Hill Professional. p. 224. ISBN 978-0-07-147186-2. Retrieved December 18, 2010.
Jump up ^ "REQUEST FOR INFORMATION:CRITICAL FOREIGN DEPENDENCIES". Wikileaks. February 2009. Archived from the original on 2016-01-05.
Jump up ^ "Potassium Iodide Dosage Guidelines & Frequently Asked Questions". Preparedness.com. 2001-12-10. Archived from the original on 2011-03-17. Retrieved 2011-03-23.
Jump up ^ "Solubility of KI in water". Hazard.com. 1998-04-21. Archived from the original on 2012-04-23. Retrieved 2013-01-21.
Jump up ^ Forster, Mark; Flenley, John R. (1993). "Pollen purification and fractionation by equilibrium density gradient centrifugation". Palynology. 17: 137–55. doi:10.1080/01916122.1993.9989424. JSTOR 3687792.
Jump up ^ "Iodine." Archived 2010-08-04 at the Wayback Machine. MedlinePlus.
Jump up ^ Saljoughian, Manouchehr (June 20, 2011). "Potassium Iodide: An Antidote for Radiation Exposure". U.S. Pharmacist. Archived from the original on February 5, 2016. Retrieved January 29, 2016.
Jump up ^ Xue, Siliang; Gu, Rui; Wu, Taixiang; Zhang, Mingming; Wang, Xiaoshan (2009). Wu, Taixiang, ed. "Oral potassium iodide for the treatment of sporotrichosis". Cochrane Database of Systematic Reviews (4): CD006136. doi:10.1002/14651858.CD006136.pub2. PMID 19821356.
Jump up ^ Marshall, JK; Irvine, EJ (1997). "Successful therapy of refractory erythema nodosum associated with Crohn's disease using potassium iodide". Canadian journal of gastroenterology. 11 (6): 501–2. doi:10.1155/1997/434989. PMID 9347164.
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Diwan-i-Khas (Red Fort)
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Coordinates: 28°39′23″N 77°14′37″E / 28.656426°N 77.243595°E / 28.656426; 77.243595
The Diwan-i-Khas in the Red Fort
The Diwan-i-Khas with red shamiana, around 1817 (by Ghulam Ali Khan)
The Peacock Throne in the mid-19th century
Interior view with the Stream of Paradise towards the Khas Mahal (before 1854, by Ghulam Ali Khan)
The Diwan-i-Khas, or Hall of Private Audiences, in the Red Fort of Delhi was the place where the Mughal emperor received courtiers and state guests. It was also known as the Shah Mahal.[1]
A gate on the north side of the preceding Diwan-i-Am audience hall led to the innermost court of the palace called Jalau Khana and the Diwan-i-Khas.[2] Originally there were two enclosures on the west of the hall, one for the nobles and the other for those of a lower rank.[1] These arcaded courts were destroyed after the Indian Rebellion of 1857.
It measures 90 x 67 feet.[2] It consists of a rectangular central chamber, surrounded by a series of arches rising from marble piers. The lower parts of the piers are inlaid with floral designs, while the upper portions are painted and gilded. The four corners of the roof are surmounted by pillared chhatri.[1]
The ceiling, which was originally inlaid with silver and gold, was stripped bare by successive financial crises of the empire by the Jats or Marattas. The current ceiling was installed in 1911. The later Peacock Throne from after Nadir Shah's invasion once stood in this hall, towards the east side.[1][3]
Through the centre of the hall flowed the Stream of Paradise (Nahar-i-Bihisht). The building used to have red awnings, or shamianas.[4] Over the corner-arches of the northern and southern walls below the cornice is inscribed the verse of Amir Khusrow: "If there be a paradise on earth, it is this, it is this, it is this."[1] The French traveller François Bernier described seeing the Peacock Throne here. Jean-Baptiste Tavernier described seeing the throne in the Diwan-i-Am, to where it was probably moved, and described five smaller thrones with four on each corner and one in the middle of the hall.[5]
The interior was completely plundered following the Indian Rebellion of 1857. The throne, the carpets, and any other items went missing. The hall today is, therefore, only a shell of what it used to be. Recent restoration work has been redone on the panels of inlay and has also reproduced the gilded pattern on one of the pillars fronting the hall.
In the riverbed below the hall and the connected buildings was the space known as zer-jharokha, or "beneath the lattices".
Contents
[hide]
1 Gallery
2 See also
3 References
4 External links
Gallery[edit]
Interior today
One of the inlaid marble panels
See also[edit]
Diwan-i-Khas (Lahore Fort), Lahore
References[edit]
^ Jump up to: a b c d e "Diwan-i-Khas of Red Fort". Archaeological Survey of India. 2011. Retrieved 2013-12-09.
^ Jump up to: a b Murray, John (1911). A handbook for travellers in India, Burma, and Ceylon (8th ed.). Calcutta: Thacker, Spink, & Co. p. 197. ISBN 978-1175486417. Retrieved 2014-01-25.
Jump up ^ "Shah Jahan's Peacock Throne". YouTube. 2008-08-03. Retrieved 2013-12-07.
Jump up ^ "The Divan-i Khass in the Palace in the Delhi Fort". British Library. 2009-03-26. Retrieved 2013-12-09.
Jump up ^ https://archive.org/stream/travelsinindia01tavegoog#page/n464
External links[edit]
Media related to Diwan-i-Khas (Red Fort) at Wikimedia Commons
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Allied health professions
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Allied health professions are health care professions distinct from nursing, medicine, and pharmacy.[1] They work in health care teams to make the health care system function by providing a range of diagnostic, technical, therapeutic and direct patient care and support services that are critical to the other health professionals they work with and the patients they serve.
Contents
[hide]
1 Professions
2 Training and education
3 History
4 Employment projections
5 See also
6 References
7 External links
Professions[edit]
In September 2012 the organization of International Chief Health Professions Officers (ICHPO) provided an agreed-upon definition of an allied health professional.[citation needed]
"Allied Health Professions are a distinct group of health professionals who apply their expertise to prevent disease transmission, diagnose, treat and rehabilitate people of all ages and all specialties. Together with a range of technical and support staff they may deliver direct patient care, rehabilitation, treatment, diagnostics and health improvement interventions to restore and maintain optimal physical, sensory, psychological, cognitive and social functions."
The International CHPO group is a network of chief officers with a professional and policy leadership role for allied health professions and supports knowledge exchange and partnership working across the international community ICHPO member countries: Australia, Belgium, Canada, Denmark, England, Hong Kong (SAR), Malaysia, Malta, Namibia, New Zealand, Northern Ireland, Scotland, Singapore, Slovenia, South Africa, Republic of Ireland, and Wales.
Depending on the country and local health care system, a limited subset of the following professions (professional areas) may be represented, and may be regulated:
Anesthesiologist assistant
Anesthesia technician
Art therapist/art psychotherapist
Athletic trainer
Autotransfusionist
Audiologist
Cardiovascular technologist
Clinical laboratory scientist
Medical transcriptionist
Medical coder
Clinical officer
Clinical psychologist
Dental hygienist
Dietitian/nutritionist
Electrocardiogram technician
Emergency medical technician
Environmental health officer
Exercise physiologist
Lactation consultant
Medical assistant
Medical interpreter
Medical laboratory scientist
Medical radiation scientist
Music therapist
Clinical neurophysiology
Occupational therapist
Operating department practitioner
Optometrist
Orthoptist
Orthotist/prosthetist
Paramedic
Pedorthist
Perfusionist
Phlebotomist
Physician Assistant
Public health epidemiologist
Physical therapist/physiotherapist
Radiotherapist/radiation therapist/medical dosimetrist
Radiographer (including specialist radiographers e.g. angiographer, mammographer, etc.)
Recreational therapist
Rehabilitation counselor
Renal dialysis technologist[2]
Respiratory therapist
Social workers
Sonographer (often, but not always, state-registered radiographers)
Speech and language pathologist
Surgical technologist
The precise titles, roles and requisites of allied health professionals may vary considerably from country to country.
Training and education[edit]
Some allied health professions are more specialized, and so must adhere to national training and education standards and their professional scope of practice. Often they must prove their skills through degrees, diplomas, certified credentials, and continuing education. Other allied health professions require no special training or credentials and are trained for their work by their employer through on-the-job training (which would then exclude them from consideration as an allied health profession in a country like Australia). Many allied health jobs are considered career ladder jobs because of the opportunities for advancement within specific fields.[3]
Allied health professions can include the use of many skills. Depending on the profession, these may include basic life support; medical terminology, acronyms and spelling; basics of medical law and ethics; understanding of human relations; interpersonal communication skills; counseling skills; computer literacy; ability to document healthcare information; interviewing skills; and proficiency in word processing; database management and electronic dictation.[4]
History[edit]
The explosion of scientific knowledge that followed World War II brought increasingly sophisticated and complex medical diagnostic and treatment procedures. Increasing public demand for medical services combined with higher health care costs provoked a trend toward expansion of service delivery from treating patients in hospitals to widespread provision of care in physician's private and group practices, ambulatory medical and emergency clinics, and mobile clinics and community-based care. In the developing world, international development assistance led to numerous initiatives for strengthening health workforce capacity to deliver essential health care services. What followed has been an increase in the need for skilled health care delivery personnel worldwide.
Changes in the health industry and emphasis on cost-efficient solutions to health care delivery will continue to encourage expansion of the allied health workforce. The World Health Organization estimates there is currently a worldwide shortage of about 2 million allied health professionals (considering all health workers aside from medical and nursing personnel) needed in order to meet global health goals.[5]
In recognition of the growth of the number and diversity of allied health professionals in recent years, the newly adopted 2008 version of the International Standard Classification of Occupations has increased the number of groups dedicated to allied health professions. Depending on the presumed skill level, they may either be identified as "health professionals" or "health associate professionals". For example, new categories have been created for delineating "paramedical practitioners"—grouping professions such as clinical officers, clinical associates, physician assistants, Feldshers, and assistant medical officers—as well as for community health workers; dietitians and nutritionists; audiologists and speech therapists; and others.[6]
Employment projections[edit]
Projections in the United States and many other countries have shown an expected long-term shortage of qualified workers to fill many allied health positions. This is primarily due to expansion of the health industry due to demographic changes (a growing and aging population), large numbers of health workers nearing retirement, the industry's need to be cost efficient, and a lack of sufficient investment in training programs to keep pace with these trends.[7][8]
Studies have also pointed to the need for increased diversity in the allied health workforce to realize a culturally competent health system in the United States[9] and elsewhere.
Workforce and health care experts anticipate that health services will increasingly be delivered via ambulatory and nursing care settings rather than in hospitals. According to the North American Industry Classification System (NAICS), the health care industry consists of three main sub-sectors, divided by the types of services provided at each facility:[10]
Hospitals: primarily provides inpatient health services and may provide some outpatient services as a secondary activity.
Ambulatory health care settings: primarily provides outpatient services at facilities such as doctors' offices, outpatient clinics and clinical laboratories.
Nursing and residential care facilities: provides residential care, such as community care for the elderly or mental health and substance abuse facilities.
In the US, a larger proportion of the allied health care workforce is already employed in ambulatory settings. In California, nearly half (49.4 percent) of the allied health workforce is employed in ambulatory health care settings, compared with 28.7 percent and 21.9 percent employed in hospital and nursing care, respectively.[11] One source reported allied health professionals making up 60 percent of the total US health workforce.[12]
In the United Kingdom there are 12 distinct professions who are considered allied health professionals; in combination they account for about 6% of the NHS workforce. In 2013 the annual expenditure on services provided by allied health professionals amounted to around ₤2 billion, although there is a lack of evidence around the extent to which these services improve the quality of care.[13]
Advancements in medical technology also allow for more services that formerly required expensive hospital stays to be delivered via ambulatory care. For example, in California, research has predicted the total consumption of hospital days per person will decline from 4 days in 2010 to 3.2 days in 2020 to 2.5 days in 2030. In contrast, the number of ambulatory visits per person will increase from 3.2 visits per person in 2010 to 3.6 visits per person in 2020 to 4.2 visits in 2030.[14]
In developing countries, many national human resources for health strategic plans and international development initiatives are focusing on scaling up training of allied health professions, such as HIV/AIDS counsellors, clinical officers and community health workers, in providing essential preventive and treatment services in ambulatory and community-based care settings.[15]
With this growing demand for ambulatory health care, researchers expect to witness a heavier demand for professions that are employed within the ambulatory sector and other non-hospital settings—in other words, allied health.[16]
See also[edit]
Health care providers
Human resources for health
Unlicensed assistive personnel
References[edit]
Jump up ^ "What is Allied Health?". Association of Schools of Allied Health Professionals. Retrieved 6 March 2014.
Jump up ^ Allied Health, Sciences. "Renal Dialysis Technology". SRU AHS. Retrieved 26 May 2014.
Jump up ^ "United States Bureau of Labor Statistics". Archived from the original on 20 April 2010. Retrieved 2010-04-24.
Jump up ^ "Explore by career: Allied Health Professions: Skills required". NHS Careers. Retrieved 17 August 2014.
Jump up ^ World Health Organization (2006), The World Health Report 2006. Geneva: World Health Organization.
Jump up ^ Dal Poz MR et al. (2009), Boundaries of the health workforce: definition and classifications of health workers. In: Handbook on monitoring and evaluation of human resources for health. Geneva: World Health Organization.
Jump up ^ "National Skills Coalition, America's Forgotten Middle Skills Jobs Report" (PDF). Retrieved 2010-04-24.
Jump up ^ "Association of Academic Health Centers Out of Order Out of Time Report". Retrieved 2010-04-24.
Jump up ^ "California Endowment, Workforce Diversity". Archived from the original on 25 May 2010. Retrieved 2010-04-24.
Jump up ^ "North American Industry Classification System". Retrieved 2010-04-24.
Jump up ^ "California Health Jobs, Help Wanted Report". p. 13. Retrieved 2010-04-24.
Jump up ^ "University of California San Francisco, Advancing the Allied Health Professions". Futurehealth.ucsf.edu. Retrieved 2012-03-06.
Jump up ^ Bardsley, Martin. "Focus on: Allied health professionals". QualityWatch. Nuffield Trust/Health Foundation. Retrieved 12 March 2015.
Jump up ^ "California Health Jobs, Help Wanted Report" (PDF). www.calhealthjobs.org. p. 14. Retrieved 18 February 2016.
Jump up ^ "PEPFAR Country Profile" (PDF). Retrieved 2012-03-06.
Jump up ^ "California Health Jobs, Help Wanted Report". Retrieved 2010-04-24.
External links[edit]
AMA Allied health professionals
Association of Schools of Allied Health Professions (ASAHP)
Allied Health Professionals on NHS Careers (UK)
[show]
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t
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Allied health professions
Anesthesia technician
Aquatic therapist
Athletic trainer
Audiologist
Dental hygienist
Dietitian
Cardiac physiologist
Emergency medical services
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Massage therapist
Medical assistants
Medical coder
Medical physicist
Medical technologist
Medical transcription
Music and arts therapist
Nutrition (clinical)
Occupational therapist
Optometrist
Phlebotomist
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Adobe Dreamweaver
From Wikipedia, the free encyclopedia
Jump to: navigation, search
"Dreamweaver" redirects here. For the song by Gary Wright, see Dream Weaver. For other uses, see Dreamweaver (disambiguation).
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Adobe Dreamweaver
Adobe Dreamweaver CC 2014.1 running on OS X Yosemite
Original author(s)
Macromedia
Developer(s)
Adobe Systems
Initial release
December 1997; 19 years ago (1997-12)[1]
Stable release
CC 2018 (18.0.0.10136) / October 19, 2017; 7 days ago (2017-10-19)
Development status
Active
Written in
C++
Operating system
Windows
macOS
Type
HTML editor, programming tool, integrated development environment (IDE)
License
Proprietary
Website
www.adobe.com/products/dreamweaver
Adobe Dreamweaver is a proprietary web development tool developed by Adobe Systems. Dreamweaver was created by Macromedia in 1997,[1] and was maintained by them until Macromedia was acquired by Adobe Systems in 2005.[2]
Adobe Dreamweaver is available for macOS and for Windows.
Following Adobe's acquisition of the Macromedia product suite, releases of Dreamweaver subsequent to version 8.0 have been more compliant with W3C standards. Recent versions have improved support for Web technologies such as CSS, JavaScript, and various server-side scripting languages and frameworks including ASP (ASP JavaScript, ASP VBScript, ASP.NET C#, ASP.NET VB), ColdFusion, Scriptlet, and PHP.[3]
Contents
[hide]
1 Features
2 Internationalization and localization
2.1 Language availability
2.2 Specific features for Arabic and Hebrew languages
3 Version history
4 See also
5 References
6 External links
Features[edit]
Adobe Dreamweaver CC is a web design and development application that combines a visual design surface known as Live View and a code editor with standard features such as syntax highlighting, code completion, and code collapsing as well as more sophisticated features such as real-time syntax checking and code introspection for generating code hints to assist the user in writing code. Combined with an array of site management tools, Dreamweaver lets its users design, code and manage websites, as well as mobile content. Dreamweaver is an Integrated Development Environment (IDE) tool. You can live preview of changes for the frontend. Dreamweaver is positioned as a versatile web design and development tool that enables visualization of web content while coding.
Dreamweaver, like other HTML editors, edits files locally then uploads them to the remote web server using FTP, SFTP, or WebDAV. Dreamweaver CS4 now supports the Subversion (SVN) version control system.
Since version 5, Dreamweaver supports syntax highlighting for the following languages out of the box:
ActionScript
Active Server Pages (ASP).
C#
Cascading Style Sheets (CSS)
ColdFusion
EDML
Extensible HyperText Markup Language (XHTML)
Extensible Markup Language (XML)
Extensible Stylesheet Language Transformations (XSLT)
HyperText Markup Language (HTML)
Java
JavaScript
PHP
Visual Basic (VB)
Visual Basic Script Edition (VBScript)
Wireless Markup Language (WML)
Support for ASP.NET and JavaServer Pages was dropped in version CS5.[4]
Users can add their own language syntax highlighting. In addition, code completion is available for many of these languages.
Internationalization and localization[edit]
Language availability[edit]
Adobe Dreamweaver CS6 is available in the following languages: Brazilian Portuguese, Simplified Chinese, Traditional Chinese, Czech, Dutch, English, French, German, Italian, Japanese, Korean (Windows only), Polish, Russian, Spanish, Swedish and Turkish.[5]
Specific features for Arabic and Hebrew languages[edit]
The older Adobe Dreamweaver CS3 also features a Middle Eastern version that allows typing Arabic, Persian, Urdu, or Hebrew text (written from right to left) within the code view. Whether the text is fully Middle Eastern (written from right to left) or includes both English and Middle Eastern text (written left to right and right to left), it will be displayed properly.
Version history[edit]
Legend:
Old version Older version, still supported Current stable version Latest preview version Future release
Developer
Major version
Minor update
Release date
Notes
Macromedia Old version, no longer supported: 1.0 1.0 December 1997 First version. Mac OS only.
1.2 March 1998 First Windows version
Old version, no longer supported: 2.0 2.0 December 1998
Old version, no longer supported: 3.0 3.0 December 1999
UltraDev 1.0 June 2000
Old version, no longer supported: 4.0 4.0 December 2000
UltraDev 4.0 December 2000
Old version, no longer supported: 6.0 MX 29 May 2002
Old version, no longer supported: 7.0 MX 2004 10 September 2003
Old version, no longer supported: 8.0 8.0 13 September 2005 Last Macromedia version. Included with Adobe CS2.3.[6]
Adobe Systems Old version, no longer supported: 9.0 CS3 16 April 2007 Replaces Adobe GoLive in Adobe Creative Suite
Old version, no longer supported: 10.0 CS4 23 September 2008
Old version, no longer supported: 11.0 CS5 12 April 2010
Old version, no longer supported: 11.5 CS5.5 12 April 2011 Supports HTML5.
Older version, yet still supported: 12.0 CS6 21 April 2012 A perpetual license (download without ongoing payments) version and a cloud (subscription) version exist with differing menu structure.
Older version, yet still supported: 13.0 Creative Cloud 17 June 2013 The perpetual license option is dropped in this version.[7][8][9][10][11][12][13]
Older version, yet still supported: 14.0 CC 2014 18 June 2014 DOM visualization tool, Live View upgrades, CSS Designer upgrades.
Older version, yet still supported: 15.0 CC 2014.1 6 October 2014 Ability to view and extract design info and images from Photoshop documents (PSDs), new templates, Live View upgrades, and 64-bit architecture.
Older version, yet still supported: 16.0 CC 2015 16 June 2015 Responsive design capabilities with visual media query bars, direct integration with the Bootstrap framework, ability to preview and inspect content on mobile devices, and improvements to the code editor.
Current stable version: 17.0 CC 2017 2 Nov 2016 Adobe release notes - Redesigned code editor, CSS pre-processor support, real-time preview in browser, quick editing of related code files, changes to UI
See also[edit]
Adobe Muse
Web application
Criticism of Creative Cloud
References[edit]
^ Jump up to: a b "Dreamweaver system requirements". . Retrieved on 2013-07-21.
Jump up ^ "Adobe Completes Acquisition of Macromedia" (PDF). Press Releases. Adobe, Inc. Retrieved 15 November 2011.
Jump up ^ "Learn to build dynamic websites and web applications". Dreamweaver Developer Center. Retrieved 15 November 2011.
Jump up ^ http://kb2.adobe.com/cps/402/kb402489.html
Jump up ^ "Adobe Dreamweaver CS5: System Requirements and languages". Adobe Systems Incorporated. Retrieved 2011-01-29.
Jump up ^ "New Adobe Acrobat 8 Professional Enhances Adobe Creative Suite 2.3". Adobe Systems. 18 September 2006. Archived from the original on 23 March 2007. Retrieved 10 January 2014. Adobe Creative Suite 2.3 Premium also bundles Dreamweaver® 8
Jump up ^ Adobe's Subscription-Only CC Release Carries Obvious Upside But Big Risk | Forbes
Jump up ^ Adobe exec: Creative Cloud complainers will love us once they try us (interview), VentureBeat
Jump up ^ Adobe's Move to the Cloud Incites Anger and Other Top Comments, Mashable
Jump up ^ Adobe Creative Cloud: Reactions, responses and reassurance | Macworld UK
Jump up ^ Neil Bennett (15 May 2013) Analysis: The real reason Adobe ditched Creative Suite for Creative Cloud, Retrieved on 2013-07-21, www.digitalartsonline.co.uk
Jump up ^ Adobe’s Creative Cloud Sparks Thunderous Revolt, 25 May 2013, truth-out.org
Jump up ^ Some Artists Give Adobe's Cloud Switch a Critical Review Archived June 16, 2013, at Archive.is, Fox Business
"Adobe Unveils Milestone 2015 Creative Cloud Release", News Release, Adobe Systems, 16 June 2015.
"New features summary: Adobe Dreamweaver CC (2015 release)", Dreamweaver Help, Adobe Systems.
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