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PubMed1992

[Endemic goiter in the area of Mielec].

The scope of this report is the incidence of goiter in school children living in Mielec and neighbouring villages. We examined a group of 3537 children aged 6-14. The enlargement of thyroid gland was observed in 49.3% of the population. Judging by the results of the research this region can be regarded as endemic. There might be several reasons for a high incidence of goiter in this region. The most important are: insufficient iodine prophylaxis, pollution of the environment including the pollution with radioiodine after the damage of the Chernobyl reactor.

Adolescent↗
PubMed1992

[Changes in laboratory parameters of thyroid function in children with simple goiter from the Mazovia region].

Endocrinological Out-Patients Clinic at Children's Hospital in Dziekanów Leśny takes care of the children from Mazovia region. Hormonal findings in children with simple goiter were analyzed in several groups of patients. In all those patients preferential T3-secretion and decreased T4 production was found. These findings allow to conclude, that in Mazovia region there is iodine deficiency, which is probably the main cause of goiter development.

Goiter, Endemic↗
PubMed1992

[Prevalence of goiter in children of the Poznan province].

The aim of our study was the evaluation of goiter prevalence in the children in Poznań and surrounding towns and villages. In 3065 children 4-16 years old the thyroid size and serum concentration of T3, T4 and TSH were determined. Our results indicate that the goiter prevalence in the group of investigated children was 20%. We also observed that the changes in the concentration of thyroid hormones and TSH were not associated with the clinical symptoms of thyroid gland dysfunction.

Adolescent↗
PubMed1991

[Effectiveness of iodine prophylaxis and frequency of thyroid enlargement (thyroid goiter) and clinical diagnosis of thyroid diseases in inhabitants of the Szczecin region after the Czernobyl accident].

The study, supported by program MZ-XVII, was carried on 4567 inhabitants of the area of Szczecin (2350 females and 2217 males). The population was chosen randomly, according to a simple drawing scheme. All subjects were clinically examined using standardised questionnaires. In 3468 persons (including 1807 girls and women, 1661 boys and men) apart form clinical examination, the assessment of thyrotropin, thyroxine and triiodothyronine in serum and frequency of antithyroglobulin antibodies and antithyroid membrane antibodies were evaluated. The data indicate that 94% of children in Szczecin's region received the prophylactic dose of iodine, mostly between the 1st and the 5th of May 1986. Only 17% of the adults received iodine. The most common preparation was Lugol solution given in a single dose. Among all persons who received iodine, only in 5% of subjects the side effects were noted (mostly in children), including symptoms of gastrointestinal tract (vomiting, abdomen pain) and occasionally intrathyroid side effects (thyroid pains). In examined population the high frequency of thyroid enlargement, mainly in women (up to 43-44% at the age group 30-50 years) was found. The frequency of clinical diagnosis of thyroid disease was higher in women than in man (most often the diffuse goiter, rarely the nodular goiter). The frequency of thyroid enlargement and clinical diagnosis of thyroid disease was not dependent on prophylactic iodine intake. The iodine prophylaxis did not influence on thyroid hormones and TSH serum levels and on frequency of antithyroid antibodies.

Adult↗
PubMed1991

[Migration inhibition test with thyroid membrane antigen in Graves-Basedow disease and nodular goiter].

The evaluation of the migration inhibition test with thyroid membrane antigen was carried out in 20 patients with Graves' disease, 13 patients with neutral nodular goiter and 13 healthy subjects. A significant inhibition of migration by thyroid antigen as compared to the control group was demonstrated only in the patients with Graves' disease (the value of the migration index was 0.57 +/- 0.07). The respective value was 0.79 +/- 0.16 in patients with nodular goiter and 0.85 +/- 0.11 in healthy subjects. The results obtained indicate the practical value of the migration inhibition test in diagnosing the thyroid diseases having an autoimmune background.

Adult↗
PubMed2003

[A study on the variation of goiter rates, urinary iodine and household salt iodine intake among children in West China].

OBJECTIVE: To study the factors leading to the variation of children's total goiter rates, urine iodine and salt iodine in West China. METHODS: Design effect (DEFF) was used to evaluate the variation of indicators. RESULTS: DEFF of children's total goiter rate was about 3.0 in 9 provinces, and the proportion was 75.0%. The DEFF of urine iodine was 1.0 - 3.5 in 6 provinces, and the proportion was 50.0%. The DEFF of intake rate of qualified iodized salt was over 3.0 in 11 provinces. The DEFF of covering rate of iodized salt was about 3.0 in 4 provinces. CONCLUSION: In order to provide scientific basis for IDD surveillance in China, other than bias due to methods of no-sampling, sample size should be further calculated in West China. Thus the main influencing factors of indicator variation could be measured with scientific and reasonable basis.

Child↗
PubMedDate not supplied

Retrosternal goiters: safety of surgical treatment.

Retrosternal goiters still pose a problem to expert endocrine surgeons. Whether surgery should be the treatment of choice or not remains controversial because of hypothetical increased morbidity rates associated with the surgical approach. Eighty-three patients were retrospectively reviewed for anesthetic risk, fibrobronchoscopic guidance for intubation, surgical technique, mortality and morbidity rates, and pathological findings. We found 6.09% of American Society of Anesthesiologists (ASA) I, 41.46% of ASA II, 40.24% of ASA III, and 12.19% of ASA IV risk. Twelve patients (14.45%) required fibrobronchoscopic guidance for intubation. Only one patient required a sternotomy. No mortality occurred. Seven patients (8.43%) had major complications, but there were no instances of permanent recurrent laryngeal palsy or hypocalcemia. Pathological examination revealed 9.63% incidence of malignancy. Surgery should be the treatment of choice for retrosternal goiters because there is a significant incidence of malignancy and an acceptable morbidity rate.

Adult↗
PubMed2004

Equine goiter associated with excess dietary iodine.

Naturally occurring goiter cases are described in 2 newborn Arabian foals whose mares were supplemented with excess iodine during the final 24 w of the pregnancy. Six nursing foals and 2 mares were also affected clinically with thyroid hypertrophy. At least 12 times the maximum tolerable level of iodine supplementation was given, as the daily iodine intake for each mare was 299 mg. The prevalence of goiter cases was 2 and 9% in the mares and foals, respectively.

Animals↗
PubMed2004

[Trends of mental and somatic diseases during therapy of endemic goiter].

The trend of mental and somatic diseases was studied in 70 patients with epidemic goiter (EG) treated with L-thyroxine or iodides during 1-5-year follow-up. Borderline mental disorders (diminished memory and attention, emotional and intellectual disorders) were found to be stable in these patients. The most delicate functions of the brain, such as the capacity for analysis and synthesis, are particularly vulnerable. Irrespective of the age of a patient, his/her educational level, occupation, the size of goiter, concrete rather than abstract logic thinking are prevalent in patients with EG. Drug treatment of EG only improves the patients' health status, but fails to eliminate evolving mental disorders even if the sizes of the thyroid can be brought to the normal values, the use of L-thyroxine is more effective that that of iodides.

Adaptation, Psychological↗
PubMed2002

[Long term course after thyroidectomy for euthyroid nodular goiter].

Every patient operated for nodular goiter by a partial surgery is exposed to recurrence. In order to verify this idea, the authors followed 36 patients operated on for nodulargoiterat least 10 years ago. A clinical examination for all the patients and echographic study for 24 of them allowed the detection of recurrence and the evaluation of survival and recurrence without any opotherapy. It seemed that clinical recurrence is observed in 16.65% of cases whereas echographic study revealed recurrence in 50% of patients examined. Only two patients were reoperated on. The predictive factors of the recurrence are geographic endemic origin and ethny, partial surgery and vesicular goiters. With 66.65% of survival without recurrence at 18 years without opotherapy, the authors argue about the utility of such treatment.

Adult↗
PubMed2005

Multinodular goiter management in Western Saudi Arabia.

OBJECTIVE: The aim of this study was to provide epidemiological data and summarize the different modalities of management of multinodular goiters (MNG) in the Western Province of Saudi Arabia (KSA). METHODS: A total of 135 patients had MNG, which were diagnosed by ultrasonography at King Abdul-Aziz University Hospital in Jeddah, KSA between January 2003 and June 2004. The data collected includes the age, gender, physical examination of the thyroid gland (trifluorothymidine, free thyroxine, free triiodothyronine, thyroid stimulating hormone), ultrasonographic findings and Tc99 radioiodine nuclear scan of the thyroid gland, fine needle aspiration (FNA) of the gland and antithyroid antibodies. The study group was divided according to the thyroid status: nontoxic euthyroid MNG, hypothyroid MNG and toxic hyperthyroid MNG. The management of MNGs according to the patients' clinical presentations and thyroid status was reviewed. RESULTS: The mean age was 39 +/- 12.66 years with a range of 10-79 years. Forty-two patients (31%), with no history of thyroid cancer, had ultrasoundguided FNA; 41 (97.6%) of the FNAs were benign. One FNA (2.3%) was positive for papillary carcinoma in a 56-year-old female patient. Thyroid antibodies (anti-microsomal antibodies and anti-thymoglobulin antibodies) were measured in 50 patients (37%). Thirty-one (62%) were positive, 11 (35%) of which were positive in patients with documented hypothyroidism. All patients with hypothyroidism were treated with levothyroxine; however, only 25.6% with euthyroid MNG were treated with suppressive doses of levothyroxine. Twelve patients (44.4%) with toxic MNG were treated with antithyroid medications. Radioiodine therapy was not given to any patient with nontoxic MNG; however, 48% of those with hyperthyroid MNG received radioactive iodine treatment. Surgery was carried out in 25.6% of patients with euthyroid nontoxic MNG, and in 11 patients with toxic MNG. Nearly half of those with nontoxic MNG (46.5%) and 14.8% of those with a subclinical hyperthyroid MNG refrained from any therapy. They were followed-up by their clinician in the outpatient clinic. CONCLUSION: Serum thyroid stimulating hormone levels, ultrasound and fine needle biopsy were the cornerstones of the diagnostic evaluation of patients with MNG. Review of the management of these patients was comparable to that found in the literature. The treatment strategy was similar to the recommendations by the American Thyroid Society; however, radioactive iodine treatment was not used as a treatment for patients with nontoxic goiters.

Adolescent↗
PubMed2005

[Lymphoepithelial cyst of the thyroid coexistent with amyloid goiter].

A case of amyloid goiter in a 73-year-old man with systemic amyloidosis complicating long lasting rheumatoid arthritis is reported. The thyroid gland was massively infiltrated with amyloid and contained foci of fat tissue and epithelial solid cell nests. Incidentally, a cyst lined by squamous epithelium, with small amount of lymphocytes in the subepithelial stroma was found. This cyst fulfilled the criteria for the diagnosis of a lymphoepithelial cyst presumably of branchiogenic origin. The herein described case of simultaneous occurrence of branchiogenic cyst and amyloid goiter represents, to our best knowledge, a unique coexistence of these two entities. The possible relationship between these lesions and their differential diagnosis is discussed.

Aged↗
PubMed1992

[The bacteriological revolution and theories of the etiology of goiter and cretinism].

During the 19th century, a large number of researchers produced many different and even contradictory theories about the aetiology of endemic goiter and cretinism. The bacteriological revolution, i.e. the acceptance of the germ theory of infectious diseases, pushed scientists to try to isolate a germ for every disease. In the case of goiter and cretinism, this was fruitless endeavour. Nevertheless, the impact of the bacteriological revolution was largely positive because it provided a new scientific model of the genesis of disease and strengthened confidence in the possibility of fighting endemic as well as epidemic disease by simple but generally applied preventive measures such as, in the present case, iodine prophylaxis.

Bacteriology↗
PubMed2005

Clinical importance of solitary solid nodule of the thyroid in endemic goiter region.

CONTEXT: Endemic area and iodine supplementation may affect the pathogenesis of the nodule which commonly occurs in endemic thyroid enlargement due to iodine deficiency. AIMS: To establish pathological changes in solitary solid and larger nodule of the thyroid in endemic area. SETTING AND DESIGN: Retrospective study in Surgical Department of University Hospital. METHODS AND MATERIAL: We determined 44 surgically treated patients with solitary solid nodule in endemic goiter area in which the population routinely receives iodinated salt. The thyroid nodule was preoperatively evaluated with blood chemistry, ultrasound, nuclear scanning and FNAC. The results of preoperative evaluation, surgical interventions, and histopathological examination were analyzed. STATISTICAL ANALYSIS: Student t test and Fisher's exact test. RESULTS: Twenty (45%;20/44) patients with hot (autonomous) nodule have received the diagnosis of toxic adenoma. Twenty four patients had solitary solid and cold nodule. Total thyroidectomy was performed on two patients with papillary cancer (PTC) diagnosed by FNAC from cold nodules. Forty two patients have been treated with total excision of the lobe including hyper or hypoactive solitary solid nodule. Pathological examination has reported two more cases of PTC and one case of insular cancer arising from cold nodules. Completion thyroidectomy was performed on these 3 patients. CONCLUSIONS: Solitary solid and large nodule is a common indication for thyroid surgery in endemic goiter area. High incidence of hyperthyroidism due to single autonomous nodule, and high rate of malignant change (mainly papillary cancer) in solitary hypoactive nodule arises from this series in endemic thyroid enlargement.

Adult↗
PubMed2005

[Sclerotherapy in patients with nodular colloid goiter].

Results of percutaneous sclerotherapy with ethanol (PSTE) in 89 patients with nodular colloid goiter were analyzed. Indications and method of PSTE in different types of nodular formations were determined. All the patients were divided into 3 groups: 1st group -- 8 (9%) patients with free-functioning nodes, 2nd -- 16 (18%) patients with symptoms of cervical organs compression, 3rd -- 65 (73%) patients with cosmetic defect on neck. It is concluded that PSTE may be regarded as alternative for surgical treatment in the patients with high surgical risk. It is not pathogenic method of treatment and it should be accompanied with medicament therapy of iodine-deficient goiter. Liquidation of clinical symptoms is the criterion of treatment efficiency.

Adolescent↗
PubMedDate not supplied

Unilateral pulmonary agenesis associated with colloidal goiter in a newborn: a case report.

Unilateral pulmonary agenesis is a very rare developmental malformation that is often associated with other anomalies. It can be asymptomatic or present with respiratory symptoms. Our case is a female newborn infant who had been taken to the hospital suffering from difficulty in breathing at the first day of birth. The baby died at the age of three days due to respiratory failure. On autopsy examination and its histopathological evaluation, we detected right pulmonary agenesis and colloidal goiter. According to the literature, pulmonary agenesis is associated with other anomalies including esophageal atresia, tracheal stenosis, musculoskeletal anomalies, DiGeorge syndrome and cardiovascular malformations such as septal defects, patent ductus arteriosus and total anomalous pulmonary venous return. To our knowledge, this is the first case of pulmonary agenesis associated with colloidal goiter.

Fatal Outcome↗
PubMed1992

[A case of anaplastic carcinoma of the mediastinal goiter].

We reported a case of anaplastic carcinoma of mediastinal goiter. The initial symptom was hoarseness, and thyroid scintigram and venogram revealed mediastinal thyroid malignant tumor, although cervical tumor could not be palpated. Operation was performed with median sternotomy. The size of the tumor was 8 x 6 x 3cm. Histological examination showed papillary adenocarcinoma of left lower pole of the thyroid gland which was transformed into anaplastic carcinoma and extended to the mediastinal cavity. Anaplastic carcinoma of mediastinal goiter is very rare, and our case showed anaplastic transformation from papillary adenocarcinoma.

Adenocarcinoma, Papillary↗
PubMedDate not supplied

[Role of diffuse nontoxic goiter in the structure of thyroid gland diseases in children].

The article presents a review of literature related to current aspects of the problem of diffuse nontoxic goiter. Etiology of the disease and the thyroid system functional state have also been given in the article. The athors emphasize the necessity of precising a number of classification issues as well as present different therapeutic approaches in treating patients with diffuse nontoxic goiter.

Child↗