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At least 613 records · Page 34Linked to original sources
PubMed1992

[Substernal goiters. 218 operated cases].

The authors are presenting a retrospective study on 218 retrosternal goiters operated between 1968 and 1991. 33% of the goiters were incidentally discovered on a plain X-ray of the chest. Symptoms of compression were present in 50.5% of patients and hyperthyroidism in 16.5%. Respiratory manifestations were more frequent and more severe in patients aged 70 and more. Moreover 90% of those old patients were symptomatic. Goiters migrated anteriorly in 57.7% of cases, posteriorly in 33.9%, both anteriorly and posteriorly in 5.5%. Type of migration was unknown in 2.5%. 3.7% were malignant. 27 patients with respiratory symptoms received corticosteroids to reduce the airway compression. Among 52 patients with hyperthyroidism, 36 were given antithyroid drugs. Among them, some received corticosteroid drugs in order to reduce risks of mediastinal compression. A simple cervicotomy was adequate in 92.7% of case and was completed by sternotomy in 7.3%. The operation was iterative for relapsing or forgotten thoracic goiters in 24 cases. Morbidity was slight even for sternotomized patients. Mortality was noted in 2 cases (0.9%) one of them operated on for poorly-differentiated and suffocating carcinoma of the thyroid. We advise a straightforward surgical attitude as a result of the slight morbidity and mortality, even in sternotomized patients in order to avoid severe compressive complications of the airways.

Adult↗
PubMed1992

[Incidence of goiter in children of the Tarnobrzeg district and environmental factors].

A group of 1897 school children from Tarnobrzeg district were examined out of this number 1241 (65.4%) children displayed goiter. Goiter incidence was also established depending upon age and sex. The analysis also included goiter incidence in relation to its size according to the WHO classification. In certain patients, newborns and their mothers, determinations of iodine excretion were made; the values were found to be within the normal. This range suggests that other etiological factors than iodine deficiency might possibly contribute to goiter development in the studied children.

Adolescent↗
PubMed1992

Iodide excretion before and after revision of goiter prophylaxis (Dutch Nutrition Surveillance System).

To assess the iodine supply in The Netherlands after the revision of the goiter prophylaxis measures (Bread Act of 1982, with an increase of iodine content of bread salt) the data of a nationwide survey among Dutch elderly people conducted in 1984/1985 were analysed. Iodide excretion in 24 h urine samples was used as the main iodine status indicator. The data were compared with data on iodine nutriture obtained among an elderly population in The Netherlands before the revision of goiter prophylaxis. High prevalences (greater than or equal to 37%) of low iodine excretion (less than 0.78 mumol/24 h; 100 micrograms/24 h) were found for Dutch elderly people. Mean urinary iodide excretion was 0.95 mumol/24 h (121 micrograms/24 h) for men and 0.79 mumol/24 h (100 micrograms/24 h) for women which is low, especially among women, in comparison with the United States recommended dietary allowance (118 mumol/day = 150 micrograms/day). Consistent positive associations of iodide excretion were found with urinary potassium and sodium excretion, bread consumption and total iodine intake. Bread, as the iodine carrier chosen for goiter prophylaxis in The Netherlands, was found to be the main dietary iodine source. No improvement in iodine nutrition was found among the elderly studied in 1984/1985 in comparison with an elderly population seen in 1981. Therefore, it is concluded that the present measures regarding goiter prophylaxis in The Netherlands might be of limited effectiveness.

Aged↗
PubMedDate not supplied

[Role of iodine and manganese in the etiology of endemic goiter in the Martuksk region of the Aktubinsk district].

Iodine deficiency in the external environment served as the main etiological factor of endemic goiter. Low iodine content in the soil (1.8-390 mg/kg) undoubtedly served as the cause of endemic goiter development. Water from the sources of the Martuksk district contained iodine in low concentration. Soils of the Martuksk district are characterized by an acute deficiency of mobile manganese. Manganese concentration in the arable soil layer (16.9-75.4 mg/kg) was regarded as reduced, this being characteristic of the foci of goiter endemia. Water manganese content (from 66 to 186 microgram/1, 99.45 +/- 10.6 microgram/1, on the average) was below the maximal permissible concentrations indicated in the International standard for drinking water. Iodine, manganese content in the soil, food products and in the water of the Martuksk district of the Aktyubinsk region indicated a reverse relationship between iodine and manganese content and the extent of endemic goiter spread.

Environmental Exposure↗
PubMed2003

[Comparative analysis of the efficacy of iodine prophylaxis in pregnant women living in endemic goiter areas].

AIM: To assess efficacy of different methods of iodine prophylaxis in pregnant women living in conditions of goiter endemia. MATERIAL AND METHODS: Standard clinical, laboratory and device tests for iodine deficiency according to WHO criteria were made in 156 pregnant women living in the territory affected by goiter endemia. Of them, 121 examinees had no thyroid pathology, 35 ones had diffuse euthyroid goiter. All of them received different kinds of iodine prophylaxis. RESULTS: The occurrence of neonatal TTH values over 5 iU/l in neonates born by mothers free of thyroid pathology on potassium iodide prophylaxis when pregnant was 9.1%. This is much lower than in conventional iodine prophylaxis--17.24% (p < 0.01). A comparative analysis of the efficacy of potassium iodide-200 in pregnant women with diffuse euthyroid goiter and its combination with L-thyroxine has shown that by the effect on lessening frequency of neonatal TTH over 5 iU/l the above schemes do not differ significantly, thyroid reduction is more prominent in pregnant women on thyroxine with potassium iodide. CONCLUSION: The index of neonatal TTH is an objective criterium to control efficacy of different methods of iodine prophylaxis in pregnancy.

Female↗
PubMed1992

[Endemic goiter in the La Kara region (Togo). Analysis of etiologic factors].

Among 6,035 people living in 3 villages from the area of La Kara (Togo), 984 randomized subjects were investigated to evaluate goiter prevalence and related etiologic factors. Creatinine and thiocyanates (SCN-) were measured in urine, thyroid hormones and TSH in plasma. Iodine was evaluated in urine, water, salt, soil, millet and sorgho. The amount of cassava was evaluated in food. Mean goiter prevalence was 32%, reaching to 45.9% in one village; urinary iodine remained in a low range (27.2 +/- 2.18 micrograms/g creatinine in adults, 34.3 +/- 6.7 in children--m +/- SEM) independently of the presence of endemic goiter. Urinary SCN- was increased. Low iodine values were found in food, salt, soil and water which contained few mineral elements except flour which was increased in the samples collected in one of the 3 villages. Cretinism was absent, T4, T3, TSH remained in a normal range. This study confirms a high prevalence of endemic goiter in the area of La Kara with iodine deficiency, leading to an urgent iodine supplementation.

Goiter, Endemic↗
PubMed2004

[Effect of three years obligatory iodine prophylaxis on the incidence of goiter in school children fron the seaside region of Poland].

UNLABELLED: In 1993 a mild iodine deficiency in the seaside region of Poland was revealed. In 1997 a mandatory iodine prophylaxis was introduced. The aim of the study was to determine the prevalence of goiter in schoolchildren aged 12-15 years from the seaside area after 3 years of obligatory iodine prophylaxis. The study comprised 628 children (291 boys and 337 girls). Thyroid size was estimated by palpation and by ultrasonography. Analysis of iodine excretion (Uroiod-Test Merck) was performed in 147 children. The goiter was found in 9% of children by palpation. The mean thyroid volume in 12 years old group was 9.3 +/- 5.1 ml, in 13 years old group 10.6 +/- 4.2 ml, 14 years old group 11.7 +/- 3.9 ml, 15 years 13.8 +/- 4.3 ml. The thyroid volume in girls was larger than that in boys. Thyroid volume above 97th percentile was assessed by ultrasound in 16% children (all of them from rural area). No goiter was found by palpation or ultrasound in children living in Gdańsk Thyroid volume is closely correlated with iodine excretion, age and height. Urinary iodine excretion above 100 micrograms/l was stated in 68% children. CONCLUSIONS: Model of obligatory iodised salt prophylaxis is highly effective and is able to increase urinary iodine excretion and decrease of goiter prevalence. Ultrasound is especially recommended for the evaluation of thyroid volume in children from previously mild iodine deficiency areas.

Adolescent↗
PubMed2004

[Diagnosis, treatment and prophylaxis of postoperative recurrent nodular goiter].

Results of surgical treatment of 81 patients with recurrent goiter and 79 patients with benign nodular forms of goiter are analyzed. Based on clinical data, results of ultrasonic and histological examinations, it was determined that recurrence of goiter does not depend on volume of surgery. It is seen in patients with subclinical forms of postoperative hypothyreosis and in half of cases with lymphoid infiltration of I - IV degree. Dispensary observation and timely prescription of suppressive therapy, if it is necessary, permit to reduce number of goiter recurrences from 8.2 to 2.5%.

Female↗
PubMed2005

Preoperative imaging of thyroid goiter: how imaging technique can influence anatomic appearance and create a potential for inaccurate interpretation.

The radiologist needs to be aware of a potential pitfall that can influence the imaging appearance of thyroid goiter. Whether the patient is imaged with the arms overhead or by the side may affect the apparent mediastinal excursion of a goiter. CT scans obtained with the patient's arms by the side are more accurate for determining substernal extent of goiter than when the arms are overhead, a position usually used in chest CT. Ultimately, this difference in imaging technique may have a profound effect on the adjacent structures impacted by the goiter and may influence the planned surgical approach.

Adult↗
PubMed2005

Substernal goiter: an unusual cause of respiratory failure after coronary artery bypass grafting.

Substernal goiter can cause extrathoracic upper airway obstruction. Since cardiopulmonary bypass results in a systemic inflammatory response syndrome characterized by an increase in capillary permeability and edematous changes in many tissues including the thyroid gland, an existing nonobstructive substernal goiter may become obstructive postoperatively. We describe the case of a patient with an asymptomatic substernal goiter who required urgent thyroidectomy for tracheal obstruction after elective coronary artery bypass grafting. To the best of our knowledge, ours is the 1st such case reported in the English-language medical literature. This case illustrates that, in cases of acute postoperative respiratory failure after open heart surgery, tracheal obstruction caused by enlarged substernal goiter should be considered in the differential diagnosis.

Acute Disease↗
PubMedDate not supplied

[Goiter transformation as a risk factor of the development of bronchial asthma in children under the influence of natural and technogenic factors of the environment].

The paper deals with the comparative characterization of the prevalence of goiter transformation in children with bronchial asthma (BA) in relation to the level of a technogenic load and natural iodine deficiency in case of the Perm Region. There was a wide distribution of goiter transformation in children, which did not correspond to natural iodine supply in the Perm Region, suggesting the contribution of anthropogenic strumogenic factors to the formation of goiter endemia. There was a high prevalence of thyromegaly in children with BA as compared with those with another disease and its high the incidence as man-made pollution increased particularly in the areas exposed to a combination of natural and technogenic factors as compared in relatively pure areas. The findings suggest that goiter transformation is a marker of ecological ill-being and an additional serious risk factor of the development and prolonged course of BA in predisposed children.

Adolescent↗
PubMedDate not supplied

[Substernal goiter: personal experience].

AIM OF THE STUDY: The Authors report on their experience in the surgical treatment of substernal goiter. MATERIAL AND METHODS: Between 1972 and 2004, 222 patients with substernal goiters were observed among 2720 patients undergoing surgical treatment for various thyroid diseases (8.16%). Seventy patients underwent subtotal thyroidectomy and 152 total thyroidectomy. A cervical approach was employed in 213 cases, a sternotomy was required in 7 patients while a thoracotomy was necessary in 2 cases. Postoperative complications were definitive hypoparathyroidism in 9 cases (4%), recurrent laryngeal nerve palsy in 5 patients (2.2%) and postoperative bleeding in 4 cases (1.8%); there was no intraoperative mortality. CONCLUSIONS: In substernal goiter it is necessary to define its exact relationship to neck and mediastinal structures in order to establish the most appropriate surgical approach. In the majority of the cases total thyroidectomy is possible through a cervical approach with an acceptable morbidity rate. When dissection of the substernal goiter is difficult and recurrent laryngeal nerve is not clearly identified, partial sternotomy is required to enable a better control of the nerve and the vessels with only a minimal morbidity rate. Thoracotomy is rarely necessary.

Adult↗
PubMed2006

[Methemoglobin and osmoresistance of erythrocytes in patients with different types of goiter].

The purpose of this study was to determine the level of methemoglobin in the blood and osmoresistance of erythrocytes in patients with different types of goiter and control subjects. Investigated parameters indicate to the antioxidant status of human organism. We examined 12 healthy controls and 49 hyperthyroid patients: 17 patients with nodular goiter (mild thyrotoxicosis), 22 patients with diffuse toxic goiter (high level of thyrotoxicosis) and 10--with euthyroid nodule goiter. Osmoresistance of erythrocytes was measured by differential photoelectrocolorymetric method and methemoglobin--by spectroscopic method. We had received significant correlation between the level of methemoglobin, osmoresistance of erythrocytes and the degree of thyrotoxicosis. The results once again prove sensitivity of antioxidant status in response to toxicity, in particular against thyrotoxicosis.

Adult↗
PubMedDate not supplied

[Antioxidant system activities and lipid peroxidation in nodal and non-nodal thyroid tissue of patients operated in connection with euthyroid nodular goiter].

The activities of the antioxidant systems (AOS) and lipid peroxidation (LP) were studied in the thyroid (operation material) of patients with euthyroid nodular goiter (in carcinoma, adenoma, colloid goiter tissues as well as in non-nodular adjacent thyroid tissue). Increased activities of superoxide dismutase (SOD, by 101.0 and 125.9%), catalase (by 76.6 and 71.2%), glutathione peroxidase (by 109.6 and 249.2%), glutathione reductase (by 84.6 and 195.9%) and LP aldehyde products (by 148.5 and 120.4%) were found in the adenoma and carcinoma tissues. The increased antioxidant system activity (SOD by 1.62-fold) and LP level by 1.62-1.65--fold in the non-goiter adjacent tissue from these patients indicate toxicity of malignant and non-malignant tumors for the adjacent normal thyroid tissues. Marked activation of oxidative stress (increased SOD activity (by 38.8-40.7%) reduced glutathione (52.4-90.0%) and TBARS concentrations (37.6-52.7%) in the nodal and non-nodal thyroid tissue in patients with multinodular colloid goiter suggest participation of free radical mechanisms in the disturbance of thyrocytes iodine metabolism and development of thyroid nodular pathology.

Adenocarcinoma↗
PubMed1990

Ouham-Pendè: a new endemic goiter area in Centro-African Republic (C.A.R.). Preliminary observations on school children.

In this work, the Authors make several epidemiological observations and report a series of biohumoral data relative to a new endemic goiter area in the north-western region of the Centro-African Republic (CAR). In this province whose chief-town is Bocaranga, living conditions are very poor and primitive, manioca being the staple food. The survey was carried out in 11 rural schools and in 2 schools in the chief-town; 4009 subjects were examined; 2839 were males, 1170 females. The goiter prevalence observed in the whole sample population was 79.75%. The prevalence for each step of the grading were: 34.6% for 1a; 32.9% for 1b; and 11.8% for 2. In the schools of the chief town the goiter prevalence was found to be significantly lower than in the rural schools (71.9% versus 83.6% with P less than 0.01). Being the goitrous F/M ratio equal to 1.041, the goiter prevalences and gradings in females were higher and more severe than in males. After calculating these differences by means of the cumulated frequencies and the Kolmogorov Smirnov test, they were found to be significant. In 45 goitrous subjects, high TSH (7.19 microU/ml +/- 5.1), T3 (1.65 ng/ml +/- 0.56), and TG serum levels (410 ng/ml +/- 280) were found; however, low normal levels were observed for rT3 (8.97 ng/dl +/- 7.5) and fT4 (0.50 ng/ml +/- 0.51). In 42 casual urine samples, iodine excretion was 23.2 micrograms/l +/- 12.8; thyocianate excretion was 9.72 mg/l +/- 6 with a I/SCN ratio = 2.38.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Clinical, laboratory and immunologic effects of the treatment of endemic goiter with T4, T3 and KI.

We treated 204 patients with endemic nontoxic goiter with T4, T3 and KI, singly or in combination. Definitely nodular goiters were excluded, since the possibility of autonomy would be increased. Goiter size was evaluated before and 6 months after treatment clinically in a blind way, i.e. the observer (always the same) did not know either the pretreatment goiter size or the treatment the patient had received. At the same time various laboratory parameters were recorded. All the active treatments (but not placebo) resulted in a highly significant decrease in the gland size. The effectiveness decreased in the following order: 1) T3 50 micrograms/d (most effective), 2) (T4 50 micrograms/d + T3 12.5 micrograms) x 2, 3) T4 150 micrograms + iodide 150 micrograms/d, 4) T4 75 micrograms + T3 18.75 micrograms/d, 5) T4 200 micrograms/d, 6) T3 37.5 micrograms/d, 7) Iodide 300 micrograms/d, 8) T4 150 micrograms/d, 9) Iodide 150 micrograms/d (least effective) and 10) Placebo (not effective). The results show that T4 200 micrograms and T3 50 micrograms are roughly equipotent, and slightly more effective than 300 micrograms of Iodide. Taking into consideration the side effects (increase in pulse rate, shortening of the Achilles tendon reflex) did not change the order of effectiveness in an important way. The clinical outcome correlated in general with the suppression of the 131I uptake (r = 0.220, p = 0.03) and the TRH test (r = 0.248, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗
PubMed1991

[Substernal goiter].

In a series of 363 patients operated for goiter, 60 were retrosternal (16.5%). The female incidence although less than in cervical goiters remains predominant (2.5:1). Most patients are in older age group, 68% being above 40 years. The majority of goiters are multinodular and of long duration. Bilateral (37%) and left sided location (43%) were common. The incidence of cancer was 7%, thyrotoxicosis was noted in 5 patients (8%). Most patients were symptomatic (97%). Diagnosis is easily done by physical examination, chest X-ray and thyroid scintigraphy. Computed tomography might be helpful. Retrosternal goiter is an indication to surgery except in high risk patients. The cervical approach has been used in 98% of cases. There were no post-operative death and no major complications (compressive hematoma, laryngeal nerve paralysis, hypocalcemia).

Adult↗
PubMedDate not supplied

[Histochemical characteristics of some oxidation-reduction hydrolytic enzymes in different forms of goiter].

Histochemical study of some enzymatic systems was conducted in various form of goiter. A study was made of the thyroid gland tissue obtained during the operation in 96 patients. Euthyrosis was accompanied by a decrease in the succinic dehydrogenase, cytochromoxidase, iodide peroxidase, acid and alkaline phosphatase activity. As to thyrotoxic goiter - it displayed an increase in the activity of these enzymes and desquamation of the follicular epithelium; the rejected cells possessed a high acid phosphatase activity. In comparison with thyrotoxic goiter, Askinazi's cell count was increased in the euthyroid macrofollicular nodular and diffuse goiter.

Acid Phosphatase↗