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The aim of the study carried out in 1989-90 and 1998-99 was to define the iodine deficiency state and goiter prevalence in adult population of Cracow. The analysis included data obtained from 230 individuals (143 females and 87 males). The mean age was 36 +/- 15 years. The thyroid size and morphology was determined by ultrasound method using Aloka unit equipped with 7.5 MHz linear transducer. The concentration of iodine in casual morning urine sample was measured using Sandell-Kolthoff's method. The 10- year observation revealed an insignificant decrease in prevalence of goiter from 26.2% to 21.8%. We observed statistically significant (p = 0.001) decrease in the parenchymal goiter prevalence from 22.7% to 11.7 in the same period of time. The significant increase in incidence of nodular goiter was found (6.5% vs 20.8%, p < 0.001). In all groups investigated through 1989-99, there was an increase in medians of ioduria over the 10-year period. The level of urinary iodine excretion was not essential element for risk of nodular goitre. Thus, the results indicate the beneficial effect of iodine prophylaxis which reflects in decrease of prevalence of parenchymal goiter. No clear effect of iodine prophylaxis was noticed regarding rise in nodular goiter incidence.

Although thyroid carcinoma is more common in the adult population, the risk of a nodule being malignant is greater in children. The aim of our present investigation was to ascertain the percentage of malignancy in nodular goiter observed in patients from the Lower Silesia region in the last 12 years. The examination included 60 children (12 boys and 48 girls) treated in our clinic from 1987 to June 1998. Age varied from 7 to 18 years (mean 14.8 +/- 2.4), most of them in the age group between 13 and 18 years. The following investigations were performed: TSH, T3, T4, thyroid ultrasonography, fine needle aspiration biopsy and Tc99 scintigraphy of the thyroid. Most of the patients were euthyroid; two children demonstrated pressure symptoms. All the patients were treated by operation. Histological examinations revealed the following: nodular goiter in 19 patients, cystic nodular goiter in 5, follicular adenoma in 20, fetal adenoma in 3, nodular goiter and follicular adenoma in 6, papillary carcinoma in 6, and follicular carcinoma in 1 patient. We concluded that an increased incidence of thyroid cancer has been noted in children with nodular goiter in Lower Silesia during the last 12 years. Thyroid cancer was observed mostly in patients with single nodules and was associated with a high risk of malignancy.

The study was aimed at the evaluation of incidence of goiter in the population of the community of Sejny. The survey comprising 1520 subjects revealed the presence of thyroid enlargement in 31.8% of the subjects studied, indicating the occurrence of a mild endemy. The facts speaking for this type of endemy are: predominance of cases with goiter of OB or I degree (83%), higher incidence of goiter in women than in men (3.3 times), occurrence of nodular goiter in 12% of cases with goiter, and sporadic appearance of hypothyroidism. Goiter endemy in the population of this area can be attributed to such goitrogenic factors as low level of iodine and high content of calcium in the water, tobacco smoking, and a habit of drinking tap water.