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У подростков с диффузным нетоксическим зобом (ДНЗ), проживающих в условиях легкого йодного дефицита, путем анкетирования проведен анализ рациона питания и его влияния на содержание витаминов и микроэлементов. Установлено, что недостаток в питании продуктов животного происхождения (рыбы и мяса) сопровождается снижением уровня витаминов В1, В2 и Е. У подростков с ДНЗ, использующих при приготовлении пищи йодированную соль, определяли более высокие показатели селена и витамина А. Среди них реже диагностировали зоб II–III степени.Для профилактики и лечения ДНЗ у детей и подростков, проживающих в условиях легкого йододефицита, необходимо включение в рацион питания продуктов животного происхождения, морепродуктов, а также обязательное использование йодированной соли. В случае выявления сочетанного дефицита йода, селена и витаминов, особенно при отсутствии полноценного питания, необходимо сочетанное назначение препаратов калия йодида, селена, витаминов А и группы В.

Вивчена вікова динаміка вмісту цинку (Zn) у хлопців пубертатного віку та його зміни при затримці росту та статевого розвитку. Мета дослідження: поглиблення існуючих уявлень щодо впливу дефіциту Zn на формування порушень фізичного та статевого розвитку в підлітків. Матеріали та методи. У 70 хлопців-­підлітків 10–17 років оцінено вміст Zn з урахуванням характеру соматостатевого розвитку, наявності дифузного нетоксичного зоба (ДНЗ). Підлітки розподілені на групи: 1) 20 хлопців 10–17 років із нормальним об’ємом щитоподібної залози, нормальним фізичним та статевим розвитком; 2) 17 хлопців 14–17 років із нормальним статевим розвитком та ДНЗ; 3) 15 хлопців 14–17 років із затримкою статевого розвитку (ЗСР) та нормальним об’ємом щитоподібної залози; 4) 18 хлопців 14–17 років із ДНЗ та ЗСР. Результати. Найбільший рівень Zn визначали у період власне пубертату при фізіологічному його перебігу ((16,52; 14,27–18,66) ммоль/л), що вірогідно більше, ніж у препубертатному віці ((13,53; 12,77–16,41) ммоль/л; p < 0,05) та в період пізнього пубертату ((12,59; 10,22–16,07) ммоль/л; p < 0,05). У хлопців із ЗСР ((14,41; 12,67–15,83) ммоль/л) та низьким зростом ((12,53; 8,80–15,46) ммоль/л) діагностовано зменшення рівня Zn, особливо в разі наявності в них ДНЗ ((10,03; 8,51–13,76) ммоль/л). Під час регресійного та факторного аналізу вивчено характер взаємозв’язку між антропометричними показниками, ступенем розвиненості вторинних статевих ознак і рівнем Zn, функціональним станом статевої та тиреоїдної системи. Визначена необхідність проведення вторинної профілактики та корекції дефіциту Zn із застосуванням «Цинкіту» у вигляді моно- або комплексної терапії. Висновки. Протягом пубертату змінюються показники Zn із максимальним його рівнем у період власне пубертату. Затримка росту та статевого розвитку відбувається на тлі зменшення концентрації Zn у крові. Найменший рівень Zn притаманний підліткам із ДНЗ та ЗСР. Вивчено характер взаємозв’язку між антропометричними показниками, ступенем розвиненості вторинних статевих ознак із Zn, функціональним станом статевої та тиреоїдної системи. Обґрунтовано доцільність застосування «Цинкіту» при проведенні вторинної профілактики та лікування дефіциту Zn у підлітків із порушенням соматостатевого розвитку.

Introduction: Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer mortality worldwide. Recent animal studies suggest that thyroid hormone treatment improves HCC prognosis. The aim of this study was to describe the association between thyroid disease and HCC prognosis in humans. Methods: We performed a nationwide cohort study including all persons with an HCC diagnosis from 2000 to 2018. Patients’ age, sex, HCC treatment, and diagnoses of thyrotoxicosis, nontoxic goiter, and myxedema were obtained from Danish national healthcare registries. We used regression models to examine the association between thyroid disease and mortality hazard and restricted mean survival time after HCC diagnosis, adjusting for confounding by sex and age. Results: We included 4,812 patients with HCC and 107 patients with thyroid disease. Median follow-up time was 5 months (total 5,985 person-years). The adjusted mortality hazard ratio was 0.68 (95% CI: 0.47–0.96) for thyrotoxicosis and 0.60 (95% CI: 0.41–0.88) for nontoxic goiter. The restricted mean survival time during the 5 years following HCC diagnosis was 6.8 months (95% CI: 1.1–12.6) longer for HCC patients with thyrotoxicosis than for patients without thyroid disease, and it was 6.9 months (95% CI: 0.9–12.9) longer for HCC patients with nontoxic goiter than for patients without thyroid disease. Conclusions: In this large nationwide cohort study, thyrotoxicosis and nontoxic goiter were associated with prolonged HCC survival.

A clinical case of successful surgical treatment of a patient with a giant cervical retrosternal nontoxic goiter with severe cardiac pathology is presented. Thyroidectomy from cervical access without sternotomy was performed. At the follow-up examination 5 months after the operation, instrumental and clinical signs of disease relapse were not detected.

Immunopathogenesis of inflammatory and dystrophic diseases of the tissues of the oral cavity is characterized by cellular and humoral factors of specific and nonspecific resistance, the functioning of which is determined by the overall somatic state. This study aimed to study the features of protective mechanisms of the oral cavity due to orthodontic pathology, pathology of periodontal tissues, and odontogenic inflammatory process in children with diffuse nontoxic goiter. Eighty children with diffuse nontoxic goiter aged 12-15 years with different dental status were examined. Evaluation of local immunity of the oral cavity was carried out by determining the content of sIgA, IgA, IgG, lysozyme activity, and levels of IL-1β, IL-4 by enzyme immunoassay. Immunological studies have shown that in children with diffuse nontoxic goiter, the activity of lysozyme in the oral fluid is decreased. The level of sIgА is also reduced by about 20%. Besides, there is an increase in the content of IgG and a growing trend in the level of IgА. The content of IL-1β and IL-4 in such children fluctuates more compared to somatically healthy children. In conclusion, a violation of the local protective mechanisms of the oral cavity is observed in children with diffuse nontoxic goiter. Also, the increase in the severity of dental pathology leads to increased tension of local protective and compensatory reactions.

Objective of the work was development of new adequate methods of pathogenic correction of periodontal tissue diseases in children with comorbid pathology of the thyroid gland. Material and methods. To solve the tasks 50 children aged from 12 to 15 years were examined including 25 children with diffuse nontoxic (simple) goiter and 25 somatically healthy children. The suggested complex of therapeutic measures included professional oral hygiene at a local level and the use of the medicine “Lizak”. A common treatment included a complex vitamin-mineral drug “Calcemin advance” and immune stimulator “Imupret” against the background of basic iodine therapy. Results. On the whole for the two years of the suggested therapeutic-preventive measures we have managed to increase the number of healthy sextants in teenagers from 1,12±0,11 to 5,78±0,47 (р, Цель работы — разработка новых адекватных методов патогенетической коррекции заболеваний тканей пародонта у детей с сопутствующей патологией щитовидной железы. Материал и методы. Для решения поставленных задач проведено обследование 50 детей в возрасте 12–15 лет. Из них 25 детей, больных диффузным нетоксичным зобом и 25 соматически здоровых детей. Предложенный комплекс лечебных мероприятий включал в себя на местном уровне профессиональную гигиену полости рта, применение препарата "Лизак". В общее лечение входил комплексный витаминно-минеральный препарат "Кальцемина аванс" и иммуностимулятор "Имупрет" на фоне базовой йодотерапии. Результаты. В целом за два года проведения предложенных нами лечебно-профилактических мероприятий удалось увеличить количество здоровых секстантов у детей подросткового возраста с 1,12±0,11 до 5,78±0,47 (р, Мета роботи — розробка нових адекватних методів патогенетичної корекції захворювань тканин пародонта у дітей із супутньою патологією щитоподібної залози. Матеріал і методи. Для вирішення поставлених завдань проведено обстеження 50 дітей віком 12–15 років. Із них 25 дітей, хворих на дифузний нетоксичний зоб та 25 соматично здорових дітей. Запропонований комплекс лікувальних заходів включав у себе на місцевому рівні професійну гігієну ротової порожнини, застосування препарату “Лізак”. До загального лікування входив комплексний вітамінно-мінеральний препарат “Кальцемін аванс” та імуностимулятор “Імупрет” на тлі базової йодотерапії. Результати. У цілому за два роки проведення запропонованих нами лікувально-профілактичних заходів вдалося збільшити кількість здорових секстантів у дітей підліткового віку з 1,12±0,11 до 5,78±0,47 (р

Objective — to investigate peculiarities of the heart failure (HF) course in patients with non-toxic goiter (NG).Materials and methods. Examinations involved 222 patients with HF (with previous myocardial infarction (MI)). At admission, all patients underwent a standardized assessment of their condition, determinations of the intra-cardiac hemodynamics’ parameters, thyroid hormones’ level, clinical and biochemical blood tests.Results and discussion. According to the data of the automatic regression analysis for NG, the following variables have possible relationship in patients with HF: the frequency of re-admission for 2 years (R2 = 0.381; p = 0.0001), the presence of syndrome low T3 (SLT) (R2 = 0.141; p = 0, 0001), the presence of subclinical hypothyroidism (R2 = 0,139; p = 0,0001), HDL cholesterol level (R2 = 0,09; p = 0,004), body weight (R2 = 0,052; p = 0,028), quantity of previous MIs (R2 = 0,042; p = 0,049). The lowest frequency of re-hospitalization for 2 years was registered in patients with HF without NG (15.8 %), while among patients with HF and NG, this figure was 50 % (χ2 = 27.881; p < 0,0001). In the group of patients with HF, which runs against the NG background, the frequency of SLT was 32.1 % versus 10.6 % among patients without NG (χ2 = 11.073; p < 0.001). The highest incidence of favorable HF (absence of re-hospitaliza­tion) was observed in the group of patients without NG and without SLT (49.0 %). At the same time, when combined with both HF and NG and SLT, the likelihood of re-admission is 59.2 % (9 out of 17 patients) (χ2 = 13.271; p = 0.005). In patients with NG, a tendency towards a higher incidence of subclinical hypothyroidism (15.1 %) was observed, compared with that among patients without nontoxic goiter (5.8 %) (χ2 = 3.759; p = 0.053). The groups of patients differed in serum levels of HDL cholesterol and triiodothyronine. Thus, in the group of patients with NG, the T3F level was lower, compared with the group of patients without NG (3.15 [1.93—3.64], against 3.40 [2.62—3.77] pml/l) was 7.35 % (p = 0.048) and the higher concentration of LPHD (1.18 [1.06—1.18] versus 1.06 [1.06—1.21] mmol/l) — 11.32 % (p = 0.016).Conclusions. The results of the study demonstrated significantly higher rate of re-hospitalization during 2 years in patients with heart failure and non-toxic goiter. The reason for such unfavorable heart failure course against the background non-toxic goiter is likely associated with higher frequency of syndrome of low T3. Patients with heart failure and non-toxic goiter did not differ from those without morphological pathology of the thyroid gland by age, gender distribution and parameters of intracardiac hemodynamics., Цель работы — исследовать особенности течения сердечной недостаточности (СН) у больных с нетоксическим зобом (НЗ).Материалы и методы. Обследованы 222 пациента с СН (с перенесенным инфарктом миокарда (ИМ)). При госпитализации осуществлялась стандартизированная оценка состояния, были определены параметры внутрисердечной гемодинамики, клинического и биохимического анализов крови, уровни гормонов щитовидной железы (ЩЖ). Проводилось исследование ЩЖ.Результаты и обсуждение. Согласно данным автоматического регрессионного анализа для НЗ следующие переменные имеют вероятную связь у больных с СН: частота повторной госпитализации на протяжении 2 лет (R2 = 0,381; р = 0,0001), наличие синдрома низкого трийодтиронина (СНТ) (R2 = 0,141; р = 0, 0001), наличие субклинического гипотиреоза (СГ) (R2 = 0,139; р = 0,0001), уровень холестерина липопротеидов высокой плотности (ХС ЛПВП) (R2 = 0,09; р = 0,004), масса тела (R2 = 0,052; р = 0,028), количество перенесенных ИМ в анамнезе (R2 = 0,042; р = 0,049). Наименьшая частота повторной госпитализации на протяжении 2 лет зарегистрирована у больных с СН без НЗ (15,8 %), в то время как среди больных с СН на фоне НЗ данный показатель составил 50 % (χ2 = 27,881; р < 0,0001). В группе больных с СН, протекающей на фоне НЗ, частота СНТ составила 32,1 % против 10,6 % среди больных без НЗ (χ2 = 11,073; р < 0,001). Наибольшая частота благоприятного течения СН (отсутствие повторной госпитализации) наблюдается в группе больных без НЗ и без СНТ (49,0 %). В то же время при сочетании СН одновременно с НЗ и СНТ вероятность повторной госпитализации составляет 59,2 % (9 из 17 боль­ных) (χ2 = 13,271; р = 0,005). У больных с НЗ выявлена тенденция к большей частоте СГ (15,1 %) по сравнению с таковой среди пациентов без НЗ (5,8 %) (χ2 = 3,759; р = 0,053). Группы больных отличались по сывороточному уровню ХС ЛПВП и трийодтиронина. Так, в группе пациентов с НЗ уровень трийодтиронина, по сравнению с группой пациентов без НЗ (3,15 [1,93—3,64] против 3,40 [2,62—3,77] пмоль/л) был ниже на 7,35 % (р = 0,048), а концентрация ХС ЛПВП (1,18 [1,06—1,18] против 1,06 [1,06—1,21] ммоль/л) — выше на 11,32 % (р = 0,016).Выводы. У больных с СН, протекающей на фоне НЗ, достоверно выше частота повторной госпитализации на протяжении 2 лет. Причиной неблагоприятного течения СН у пациентов с НЗ, вероятно, является большая частота СНТ. Пациенты с СН и НЗ не отличаются от больных без морфологической патологии ЩЗ по возрасту, распределению пола и параметрам внутрисердечной гемодинамики., Мета роботи — дослідити особливості перебігу серцевої недостатності (СН) у хворих з нетоксичним зобом (НЗ).Матеріали та методи. Обстежено 222 пацієнти із СН (з перенесеним інфарктом міокарда (ІМ)). При госпіталізації було проведено стандартизовану оцінку стану, визначено параметри внутрішньосерцевої гемодинаміки, клінічного та біохімічного аналізів крові, рівні гормонів щитоподібної залози (ЩЗ). Викону­валось ультразвукове дослідження ЩЗ. Результати та обговорення. Згідно даних автоматичного регресійного аналізу для НЗ наступні змінні мають достовірний зв’язок у хворих на СН: частота повторної госпіталізації упродовж 2 років (R2 = 0,381; р = 0,0001), наявність синд­рому низького трийодтироніну (СНТ) (R2 = 0,141; р = 0,0001), субклінічного гіпотиреозу (R2 = 0,139; р = 0,0001), рівень холестерину ліпопротеїдів високої щільності (ХС ЛПВЩ) (R2 = 0,09; р = 0,004), маса тіла (R2 = 0,052; р = 0,028), кількість перенесених ІМ (R2 = 0,042; р = 0,049). Найменша частота повторної госпіталізації протягом 2 років була зареєстрована у хворих на СН без НЗ (15,8 %), у той час як серед хворих на СН на тлі НЗ даний показник склав 50 % (χ2 = 27,881; р < 0,0001). У групі хворих на СН, що протікає на тлі НЗ, частота СНТ склала 32,1 проти 10,6 % у хворих без НЗ (χ2 = 11,073; р < 0,001). Найбільша частота сприятливого перебігу СН (відсутність повторної госпіталізації) спостерігається в групі хворих без НЗ та без СНТ (49,0 %). Водночас при поєднанні СН із НЗ та із СНТ імовірність повторної госпіталізації становить 59,2 % (9 з 17 хворих) (χ2 = 13,271; р = 0,005). У пацієнтів із НЗ виявлено тенденцію до більшої частоти субклінічного гіпотиреозу (15,1 %) порівняно з такою серед пацієнтів без НЗ (5,8 %) (χ2 = 3,759; р = 0,053). Групи хворих різнилися за сироватковим рівнем ХС ЛПВЩ та трийодтироніну. Так, у групі пацієнтів з НЗ рівень вільного трийодтироніну порівняно з групою пацієнтів без НЗ (3,15 [1,93—3,64] проти 3,40 [2,62—3,77] пмоль/л) був нижчим на 7,35 % (р = 0,048), а концентрація ХС ЛПВП (1,18 [1,06—1,18] проти 1,06 [1,06—1,21] ммоль/л) — вищою на 11,32 % (р = 0,016).Висновки. Хворі на СН, що протікає на тлі НЗ, мають достовірно вищу частоту повторної госпіталізації протягом 2 років. Причиною несприятливого перебігу СН у пацієнтів з НЗ, ймовірно, є більша частота СНТ. Пацієнти із СН та НЗ не відрізняються від хворих без морфологічної патології ЩЗ за віком, статтю та параметрами внутрішньосерцевої гемодинаміки.

Alice in Wonderland syndrome (AIWS) is a rare disorder that refers to episodic body image distortions, sometimes associated with altered perception of external space and time. AIWS is mainly associated with viral disease in children as well as migraines and epileptic seizures in adults. Its pathogenesis is still very much unknown and there are not many reported drug-associated cases in medical literature. We describe a case of a 67-year-old woman, with a relevant history of depressive disorder, nontoxic goiter, and dyslipidemia that presented short episodes of altered body perception associated with altered external space perception for a period of one week. Her physical examination was unremarkable and her cerebral computerized axial tomography (cerebral CAT) and blood tests showed no alterations. She had been medicated with sertraline till the previous year and had restarted it in the previous month. She reported similar episodes of body image distortions in the first weeks of initiating sertraline for the first time. The current episode lasted for two weeks and in one year follow-up she reported no recurrence. The patient was diagnosed with AIWS probably induced by sertraline, being the first reported case of the kind.

Previous research has suggested an increased risk of death and cardiovascular disease in patients treated for hyperthyroidism. However, studies on this subject are heterogeneous, often based on old data, or have not considered the impact that treatment for hyperthyroidism might have on cardiovascular risk. It is also unclear whether long-term prognosis differs between Graves' disease and toxic nodular goiter. The aim of this study was to use a very large cohort built on recent data to assess whether improvements in cardiovascular care might have changed the prognosis over time. The study also investigated the impact of different etiologies of hyperthyroidism.This was an observational register study for the period 1976-2012, with subjects followed for a median period of 18.4 years. Study patients were Stockholm residents treated for Graves' disease or toxic nodular goiter with either radioactive iodine or surgery (N = 12,239). This group was compared to Stockholm residents treated for nontoxic goiter (N = 3685), with adjustments made for age, sex, comorbidities, and time of treatment. Comparisons were also made to the general population of Stockholm. Outcomes were assessed in terms of all-cause and cardiovascular mortality as well as cardiovascular morbidity.The hazard ratios (HR) for all-cause mortality and for cardiovascular mortality were 1.27 [confidence interval (CI) 1.20-1.35] and 1.29 [CI 1.17-1.42], respectively, for hyperthyroid patients compared to those with nontoxic goiter. For cardiovascular morbidity, the HR was 1.12 [CI 1.06-1.18]. Patients aged ≥45 years who were treated for toxic nodular goiter were generally at greater risk than others, and those included from the year 1990 and onwards were at greater risk than those included earlier. Increased all-cause mortality, as well as cardiovascular mortality and morbidity, were also seen in comparisons with the general population.This is the first large study to indicate that the long-term risk of death and cardiovascular disease in hyperthyroid subjects is due to the hyperthyroidism itself and not an effect of confounding introduced by its treatment. Much of the excess risk is confined to individuals treated for toxic nodular goiter. Despite advances in cardiovascular care during recent decades, hyperthyroidism is still a diagnosis associated with increased cardiovascular morbidity and mortality.

Background. It has been proved that pupils with thyroid diseases, in particular diffuse nontoxic goiter (DNG), suffer from digestive disorders almost 2.5 times more often. The purpose was to study the features of gastric emptying in children with diffuse nontoxic goiter. Materials and methods. The main group included children with DNG (n = 89), the comparison group — children without thyroid diseases (n = 84). A multi-faceted questionnaire survey, thyroid ultrasonography and functional ultrasonography of the stomach were conducted. Results. The prevalence of goiter among children of Bukovina was 53.3 %. The frequency of functional gastrointestinal disorders in children of both groups was 27.55 ± 2.17 %: in patients with DNG — 33.9 ± 2.3 %, in children without DNG — 21.4 ± 1.3 %, p < 0.05. Impaired gastric emptying was detected in 12 patients with DNG (11.6 %) and in 6 (8.5 %) children without DNG. Most often, these violations were registered in patients with functional dyspepsia. Conclusions. A significantly higher frequency of functional gastrointestinal disorders in children with diffuse nontoxic goiter, including impaired gastric emptying, was established. Treatment of somatic disease will reduce the frequency of unfavorable course of DNG in children and adolescents., Актуальность. Доказано, что почти в 2,5 раза чаще патологией органов пищеварения страдают школьники с болезнями щитовидной железы, в том числе с диффузным нетоксическим зобом (ДНЗ). Цель: изучить особенности моторно-эвакуаторной функции желудка у детей с диффузным нетоксическим зобом. Материалы и методы. Основную группу составили дети с зобом (89 человек), группу сравнения — дети (84 человека) без отклонений со стороны щитовидной железы. Проводилось многоплановое анкетирование, ультрасонографическое исследование щитовидной железы и функциональное ультрасонографическое исследование желудка. Результаты. Распространенность зоба среди детей Буковины составила 53,3 %. Частота функциональных расстройств органов пищеварения у детей обеих групп составляла 27,55 ± 2,17 %: у детей с ДНЗ — 33,9 ± 2,3 %, у детей без ДНЗ — 21,4 ± 1,3 %, p, Актуальність. Доведено, що майже у 2,5 раза частіше від патології органів травлення страждають школярі з хворобами щитоподібної залози, зокрема з дифузним нетоксичним зобом (ДНЗ). Мета: вивчити особливості моторно-евакуаторної функції шлунка в дітей із дифузним нетоксичним зобом. Матеріали та методи. Основну групу становили діти із зобом (89 осіб), групу порівняння — діти без відхилень з боку щитоподібної залози (84 особи). Проводилось багатопланове анкетування, ультрасонографічне дослідження щитоподібної залози й функціональне ультрасонографічне дослідження шлунка. Результати. Поширеність зоба серед дітей Буковини становила 53,3 %. Частота функціональних розладів органів травлення в дітей обох груп становила 27,55 ± 2,17 %: у дітей із ДНЗ — 33,9 ± 2,3 %, у дітей без ДНЗ — 21,4 ± 1,3 %, p < 0,05. Порушення моторно-евакуаторної функції шлунка встановлені у 12 дітей із ДНЗ (11,6 %) і 6 (8,5 %) дітей без ДНЗ. Найчастіше ці порушення реєструвалися в дітей із функціональною диспепсією. Висновки. Встановлено вірогідно вищу частоту функціональних розладів травної системи в дітей із дифузним нетоксичним зобом, у тому числі порушень моторно-евакуаторної функції шлунка. Санація соматичної патології дозволить зменшити частоту несприятливого перебігу ДНЗ у дітей і підлітків.

Objective: To determine the status of thyroid system in girls with secondary amenorrhea (SA).Patients and methods. The study included 82 girls in the age 14-17 years with SA (main group). The control group consisted of 78 girls of the same age with a normal volume of the thyroid gland (TG), harmonious physical development and normal menstrual function. Ultrasound examination and examination of the thyroid gland state are included in the study.Results. The results of visual palpation and ultrasound examination of the thyroid gland state revealed the presence of thyropathies in more than half of patients with SA: diffuse nontoxic goiter of 1-2 (9.8%), autoimmune thyroiditis (12.2%), nodular goiter (3.6%) and thyroid hypoplasia (17.1%).Conclusions a significant number of girls with SA have thyroid dysfunction due to various changes in TTH and free fractions of thyroid hormones independently on the presence of the thyroid pathology.Key words: girls, thyroid gland, thyroid status, secondary amenorrhea.

A 65-year-old male got admitted with complaints of anterior neck swelling for the past 10 years. The swelling was insidious in onset and gradually progressive in size. Initially, the swelling was of size 2 x 3 cm, which gradually progressed to its present size of about 7 x 5 cm. The swelling was not associated with pain. There was no history of difficulty in swallowing, hoarseness of voice or difficulty in breathing. There was no history suggestive of hyperthyroidism or hypothyroidism. There was no history of neck irradiation in the past or during childhood. Patient had not taken any treatment for thyroid disease and neither does the patient give history of any surgical intervention in the past. There was no history of similar swellings in the past

The aim of the research is to study the dental status of children with concomitant somatic pathology, to establish the interrelated correlations.To reach the aim the clinical observation of 460 12-15-year-old children was conducted: I group – children with chronic gastroduodenitis (90 people); II – children with dystonia (100); III – children with chronic diseases of the upper respiratory tract (90 people); IV – children with diabetes type 1 (80), V – children with diffuse nontoxic goiter (100 people). Dental status of children was assessed by the indices OHI-S, PMA, CPI, prevalence and intensity of dental caries (DMF - Decayed, Missing, Filled), non-carious lesions of dental hard tissues and dentoalveolar anomalies and deformities. Conclusions. The highest intensity and prevalence of dental caries and periodontal tissue diseases is observed in case of gastroenterological pathology (96.7 and 90.0%, respectively). Dental caries complications are often observed in children with diabetes mellitus (62.5%) and diseases of the gastrointestinal tract (44.4%). Dentofacial anomalies and deformities mostly occur in children with endocrinopathy (66% approximately). Poor oral hygiene, as well as the percentage of carious and extracted teeth in the DMF index structure indicates the need to improve dental care for these children.Development of prevention and treatment differentiated methods of children with concomitant somatic and dental pathology is promising.

The objective of the research was to assess the thyroid status of children with diffuse nontoxic goiter and its effect on dental pathology depending on age.Materials and methods. Clinical observation of 226 children at the age of 12-15 years was conducted. To analyze their thyroid status, serum levels of total thyroxine, free thyroxine, total triiodothyronine, and thyroid stimulating hormone were determined using enzyme immunoassay. The following thyroid indices were calculated for the integral estimation of the functional state of the pituitary-thyroid system: the peripheral inversion index (total triiodothyronine/total thyroxine), the integral index (total triiodothyronine + total thyroxine/thyroid stimulating hormone) and the indices of thyroid stimulating hormone/total triiodothyronine and thyroid stimulating hormone/total thyroxine. Their dental status was determined by means of standard indices recommended by the World Health Organization.Conclusions. In children with euthyroid enlargement of the thyroid gland, there were detected changes in the thyroid status within the reference range. According to the direction of changes in the most indices, dysthyroidism is characterized by the reduced thyroid function that can affect metabolic processes in the body, including the dentofacial system, as evidenced by significantly worse indices of the intensity of damage to hard dental tissues and periodontal tissues in children with diffuse nontoxic goiter.

Aim: The aim of this meta-analysis is to assess and validate the feasibility and safety of total thyroidectomy (TT) when compared to bilateral subtotal thyroidectomy (BST) for bilateral multinodular nontoxic goiter (BMNG). Materials and Methods: PubMed, Web of Knowledge, and Ovid's database were searched for studies published in English language between January 1990 and December 2014. A meta-analysis was performed to compare the complications and recurrences of TT versus BST. The search terms used were ‘total thyroidectomy', ‘bilateral subtotal thyroidectomy', ‘multinodular nontoxic goiter' and ‘randomized clinical trial'. The reference lists of relevant studies were checked manually to locate any missing studies. Results: Four trials with a total of 1,078 patients were analyzed. Although the incidence of transient hypoparathyroidism was higher in TT than in BST (OR = 2.59, 95% CI [1.58-4.24], p = 0.0002), TT was associated with a significantly lower incidence of recurrence (OR = 0.04, 95% CI [0.01, 0.17], p < 0.0001). There were no statistically significant differences for the presence of transient/permanent recurrent laryngeal nerve palsy and permanent hypoparathyroidism between the two groups. Conclusion: TT is a feasible and safe procedure for patients with BMNG. Although TT involves a significantly higher risk of postoperative transient hypoparathyroidism, it has a lower recurrence rate than BST.

Postmenopausal osteoporosis - multifactorial disease, on the pathogenesis of which affect not only the estrogen deficiency, but functional state of other endocrine glands, particularly the thyroid gland. The article presents the results of a research 74 women with autoimmune thyroiditis and diffuse nodular nontoxic goiter, which during perimenopause and menopause for 12 months received low-dose estrogen-progestin preparation containing 2 mg drospirenone and 1 mg of 17-estradiol. The control group consisted of 40 women of similar age without thyroid disease who were not receiving drugs hormone replacement therapy (HRT). To study the effect of HRT on bone metabolism all women at baseline and after 12 months of follow-conducted study of bone mineral density (BMD) with dual en ergy X-ray absorptiometry (DXA). As a result of the treatment received reliable increase in BMD in the lumbar spine L1-L4 9-10% (p

STATE OF CONNECTIVE TISSUE ELEMENTS OF THE DENTAL-MAXILLARY SYSTEM IN CHILDREN WITH DIFFUSE NONTOXIC GOITER

The use of macro- and trace elements-containing medicines against the basic iodine therapy in children with diffuse nontoxic goiter enables to make the indices of dental caries intensity stable, to improve the level of dental health and prevent the development of possible complications from the site of the maxillodental system and the body of a child as the whole.

The major cause of mortality in many countries is cardiovascular pathology. Heart failure (HF) is the final stage of the cardio-vascular continuum. Recent years, interest in the study of comorbidity in HF has increased significantly. This is due to the fact that the concomitant pathology not only affects the severity of the HF course, but also can determine the variability of the response to prescribed treatment. Non-toxic goiter (NTG) is one of the most common thyroid pathology in our country. At NTG in some patients changes in thyroid function are detected. Subclinical and clinical hypothyroidism are often observed. Thyrotoxicosis may develop over the years due to the "autonomization" of thyroid nodules. Earlier, we reported that patients with NTG have a high incidence of the low T3 syndrome (LT3S) in HF. β-blockers (β-AB) reduce mortality (up to 30%) in HF. In addition, this group of drugs did not show a significant effect on survival in decompensated patients. It is also known that β-AB lead to blockade of deiodinases, which leads to a decrease in T4 to T3 conversion, that is why they are prescribed to patients with hyperthyroidism. It can be assumed that the use of β-AB in HF in patients with NTG requires more detailed study. Objective: to study the effect of the use of β-blockers (β-AB) in patients with NTG on the course of HF. Object and research methods. 381 patients with HF on a background of post-infarction cardiosclerosis were included. In 218 (57.2 %) patients were diagnosed with NTG. Levels of TSG, T3f and T4f were evaluated. Echocardioscopy and ultrasound examination of the thyroid gland were performed. The course of HF was studied for 2 years. Results. Patients with HF without NTG who received bisoprolol at dose over 5 mg had a significant reduction in the risk of re-hospitalization (RH) (odds ratio (OR) = 0.174 (0.057-0.530), p = 0.002) and combined endpoint (CE) (OR = 0.403 (0.180-0.905), p = 0.025), comparing to patients who received β-AB at a dose lower or equal 5 mg as a result of intolerance or low compliance. It was not possible to detect a decrease in the risk of a non-sensitive course of HF with increasing dose of β-AB in the group of patients with NTG. Patients with NTG have a higher incidence of low T3 syndrome (LT3S), compared to patients without NTG (39.4 % vs. 9.8 %, respectively, at p = 0.0001). Prescribing β-AB in patients with NTG but without LT3S leads to a decrease in the risk of RH due to HF decompensation (OR = 0.399 (0.173-0.925), p = 0.029) and CE (OR = 0.419 (0.188-0.935), p = 0.031). Prescription of β-AB at a dose over 5 mg in patients with NTG without LT3S leads to a further reduction in the risk of RH (OR = 0.123 (0.035-0.431), p = 0.0001) and CE (OR = 0.224 (0.086-0.587), p = 0.001). Conclusions. The use of β-AB in patients with NTG has no dose-dependent effect on the course of HF. A probable cause of this is the high incidence of LT3S among patients in this population. The use of β-AB in patients with NTG without LT3S leads to a significant reduction in RH frequency and the risk of CE developing within 2 years.

Background: Thyroid diseases are the commonest endocrine disorders worldwide and India is no exception. Goiter may be generalized or localized, toxic or nontoxic. The present study is being carried out in a government notified endemic area to study the etiology and surgical management with postoperative complications in patients with nontoxic goiter.Methods: A observational study was carried out at a tertiary care academic hospital. Patients with a clinically diagnosed nontoxic goiter with normal T3, T4 and TSH values were included in the study. The study subjects underwent relevant investigations and surgical intervention. The outcome factors were histopathology of the surgically removed gland and postoperative complications.Results: A total of 67 patients of nontoxic goiter were enrolled. The mean age of the patients was 33.3±11.1 years with female preponderance. The mean duration of the thyroid swelling was 2+/- 2 years. Hemithyroidectomy was most common surgery (68.7%) carried out. A majority (88%) of resected thyroid specimens were benign histopathologically as colloid goiter. An intergroup analysis was carried out between metabolic, autoimmune and neoplastic etiologies. Neoplastic etiology was significantly associated with smooth surface and hard consistency of the gland. Autoimmune goiter had significantly less than 12 months duration and painful. The postoperative complications observed were hypothyroidism (22.4%), hypoparathyroidism (10.5%), RLN palsy (6%) and SSI (3%). Conclusions: Benign pathology was commonly seen with nontoxic goiter. Hypothyroidism and Hypoparathyroidism were the most frequent postoperative complications.

SUMMARY. In children with euthyroiden largement of the thyroid gland there are changes of the thyroid status within referential meanings. According to the direction of changes of the most indices thyroid dysfunction is characterized by hypo function of the thyroid gland that can affect on metabolic processes in the child’s organism, and the dento-alveolar system in particular. Its evidence is reliably worse indices of the intensity of affliction of the hard dental tissues and periodontal tissues in children suffering from diffuse nontoxic goiter. Key words: сhildren, diffuse nontoxic goiter, dental diseases. Отримано 13.10.2015

We report a case of Benson′s Syndrome, a form of occipital Alzheimer′s disease, with posterior cortical atrophy on magnetic resonance imaging, in a 62-year-old male, who presented with visual problems, ascribed to the eyes, and had even undergone cataract/intraocular lens surgery in the right eye; and change of glasses 21 times over the past 2 years, with no apparent benefit. This case is of interest both on account of its rarity, and to highlight its features since the diagnosis may be missed in an ophthalmological setting where such patient may go for first consult.

The trabectome is a novel form of ab interno trabeculectomy that ablates and remove the trabecular meshwork and the inner wall of Schlemm's canal and subsequently expose the natural drainage pathway (the collector channels) to aqueous humor. Complications associated with the trabectome are few and among them is transient hypotony. We report a case of a prolonged ciliochoroidal effusion with hypotony after ab interno trabeculectomy using the trabectome with cyclodialysis cleft detected by 80 MHz ultrasound biomicroscopy in a previously neither nonoperated nor traumatized eye. Transient hypotony has been reported after the trabectome surgery. Very few cases were associated with inadvertent intraoperative cyclodialysis, but there are no cases of prolonged hypotony with ciliochoroidal effusion with cyclodialysis. In our case, associated transient intraoperative and postoperative hypotony with a history of chronically high pressure along with the possible contribution of low-grade postoperative inflammation may have precipitated the ciliochoroidal effusion with prolonged hypotony associated with cyclodialysis.