55 results on '"Goiter, Endemic diagnostic imaging"'
Search Results
2. [Imbalance of microelements and vitamins in adolescents with diffuse nontoxic goiter and biliary dyskinesia].
- Author
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Plekhova EI, Kashkalda DA, Volkova IuV, Turchina SI, Kosovtsova AV, and Kostenko TP
- Subjects
- Adolescent, Biliary Dyskinesia complications, Biliary Dyskinesia diagnostic imaging, Biliary Dyskinesia pathology, Cadmium metabolism, Child, Cobalt metabolism, Diterpenes, Female, Gallbladder diagnostic imaging, Gallbladder pathology, Goiter, Endemic complications, Goiter, Endemic diagnostic imaging, Goiter, Endemic pathology, Hair chemistry, Humans, Iron blood, Lead metabolism, Male, Retinyl Esters, Riboflavin urine, Selenium metabolism, Sex Factors, Thiamine urine, Thyroid Gland diagnostic imaging, Thyroid Gland pathology, Thyrotropin blood, Thyroxine blood, Ultrasonography, Vitamin A analogs & derivatives, Vitamin A blood, Zinc blood, alpha-Tocopherol blood, Biliary Dyskinesia metabolism, Gallbladder metabolism, Goiter, Endemic metabolism, Thyroid Gland metabolism
- Abstract
The purpose of the present work was to study the level of microelements and vitamins in adolescents with diffuse nontoxic goiter. It has been shown that comorbid biliary dyskinesia leads to significant dysregulation of vitamin and mineral metabolism: the level of essential elements was decreased and the level of toxic elements was increased. Comorbid biliary dyskinesia in adolescents with diffuse nontoxic goiter was accompanied by a disbalance of vitamins. The changes found in micronutrients have sex differences.
- Published
- 2014
3. Spectrum and prevalence of nodular thyroid diseases detected by ultrasonography in the Western Black Sea region of Turkey.
- Author
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Aydin Y, Besir FH, Erkan ME, Yazgan O, Gungor A, Onder E, Coşkun H, and Aydin L
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Black Sea, Cohort Studies, Cross-Sectional Studies, Early Diagnosis, Female, Humans, Hypothyroidism diagnostic imaging, Hypothyroidism epidemiology, Iodine deficiency, Male, Mass Screening, Middle Aged, Organ Size physiology, Prospective Studies, Sensitivity and Specificity, Thyrotoxicosis diagnostic imaging, Thyrotoxicosis epidemiology, Thyrotropin blood, Thyroxine blood, Turkey, Ultrasonography, Young Adult, Goiter, Endemic diagnostic imaging, Goiter, Endemic epidemiology, Goiter, Nodular diagnostic imaging, Goiter, Nodular epidemiology
- Abstract
Objective: The aim of the study was to investigate thyroid diseases and the prevalence of goiter by ultrasonography (US) in a moderately iodine deficient area., Material-Methods: The MELEN Study is a prospective cohort study on the prevalence of thyroid diseases in Turkish adults. A total of 2233 subjects with a mean age of 50 (age range 18 to 92) were submitted to study. Thyroid US was performed and interpreted by the same experienced physician. Goiter prevalence was defined according to Gutekunst's criteria., Results: The most common thyroid disease was multinodular goiter (MNG) (42%), followed by nodular goiter (NG) (14.6%). The crude prevalence of nodular disease in the region was 56.6%. In the study cohort, thyrotoxicosis (TSH <0.35 μIU/ml) prevalence was 12 % and subclinical and overt hypothyroidism (TSH > 4.5 μIU/ml) prevalence was 6.5 %., Conclusion: We found that thyrotoxicosis and nodular thyroidal diseases are more important public health issues in moderate iodine deficient geographical areas. We recommend the increased rates of US screening especially in the endemic regions in order to detect thyroidal nodules earlier.
- Published
- 2014
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4. Accuracy of ultrasound elastography in the diagnosis of thyroid cancer in a low-risk population.
- Author
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Vidal-Casariego A, López-González L, Jiménez-Pérez A, Ballesteros-Pomar MD, Kyriakos G, Urioste-Fondo A, Álvarez-San Martín R, Cano-Rodríguez I, and Jiménez-García de la Marina JM
- Subjects
- Adult, Aged, Biopsy, Fine-Needle, Carcinoma epidemiology, Carcinoma pathology, Carcinoma surgery, Carcinoma, Papillary, Elasticity, Elasticity Imaging Techniques, Female, Goiter, Endemic diagnostic imaging, Goiter, Endemic epidemiology, Goiter, Endemic pathology, Goiter, Nodular diagnostic imaging, Goiter, Nodular epidemiology, Goiter, Nodular pathology, Hospitals, University, Humans, Male, Middle Aged, Risk, Sensitivity and Specificity, Spain epidemiology, Thyroid Cancer, Papillary, Thyroid Gland immunology, Thyroid Gland pathology, Thyroid Gland surgery, Thyroid Neoplasms epidemiology, Thyroid Neoplasms pathology, Thyroid Neoplasms surgery, Thyroid Nodule epidemiology, Thyroid Nodule pathology, Thyroid Nodule surgery, Thyroiditis diagnostic imaging, Thyroiditis epidemiology, Thyroiditis pathology, Carcinoma diagnostic imaging, Thyroid Gland diagnostic imaging, Thyroid Neoplasms diagnostic imaging, Thyroid Nodule diagnostic imaging
- Abstract
Objective: Stiffness has been associated to malignancy in prostate and breast, as well as thyroid. Ultrasound elastography objectively measures tissue elasticity, and previous studies have described it as a high sensitivity and specificity technique for the detection of malignant thyroid nodules in high-risk populations. The aim was to assess the accuracy of elastography in a population with low risk of malignancy., Design and Patients: 128 consecutive patients with nodular goiter were recruited. Elastography and ultrasound-guided fine-needle aspiration were performed. When malignancy was suspected by citology, surgery was recommended. Thyroid nodules were classified by elastography according the criteria described by Ueno, and an alternative classification. Sensitivity, specificity, predictive values, and odds ratio were calculated., Results: Most patients were female, aged 56.1 year, with single nodule (52.0%) or multinodular goiter (45.6%), and a few thyroiditis (2.4%). The majority of nodules were mostly elastic. Fine-needle aspiration found 86% of benign nodules, 9.3% of indeterminate, and 4.7% possibly malignant. After surgery, 3 malignant nodules were confirmed, all of them being papillary carcinomas. All the malignant nodules were mostly elastic, as well as 75% of indeterminate nodules. Low values of sensitivity and specificity were found for elastic nodules being benign and hard nodules malignant., Conclusion: In a low-risk population for thyroid cancer, elastography lacks accuracy for the diagnosis of malignant nodules., (© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
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5. Indications for surgery and significance of unrecognized cancer in endemic multinodular goiter.
- Author
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Lasithiotakis K, Grisbolaki E, Koutsomanolis D, Venianaki M, Petrakis I, Vrachassotakis N, Chrysos E, Zoras O, and Chalkiadakis G
- Subjects
- Adult, Aged, Biopsy, Fine-Needle, Female, Follow-Up Studies, Goiter, Endemic diagnostic imaging, Goiter, Endemic pathology, Goiter, Endemic surgery, Goiter, Nodular diagnostic imaging, Goiter, Nodular pathology, Goiter, Nodular surgery, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Preoperative Care, Prevalence, Retrospective Studies, Sensitivity and Specificity, Thyroid Gland diagnostic imaging, Thyroid Gland pathology, Thyroid Neoplasms complications, Thyroid Neoplasms epidemiology, Thyroid Neoplasms surgery, Treatment Outcome, Ultrasonography, Goiter, Endemic complications, Goiter, Nodular complications, Thyroid Neoplasms diagnosis, Thyroidectomy
- Abstract
Background: The exclusion of cancer in endemic goiter is often difficult mainly because of the high number of nodules and the as-yet unclear natural history of diagnosed cancer in endemic goiter patients. In a large number of consecutive patients who were to undergo total thyroidectomy for endemic multinodular goiter, we assessed indications for surgery and thyroid cancer outcome., Methods: All patients who were to undergo total thyroidectomy for diffuse multinodular goiter on histological examination between January 1990 and October 2008 were evaluated., Results: Of the 1,161 patients included in the study, 252 were cases of thyroid cancer (21.7%). Sensitivity of thyroid ultrasound (US) and fine-needle aspiration cytology (FNAC) for cancer detection was 30.3 and 64.1%, respectively. Differentiated thyroid carcinoma accounted for most of the tumors (96%), with 54.8% of them being papillary microcarcinomas, while bilateral-multicentric cancer occurred in 20.3%. In multivariate analysis, younger age (p = 0.06), sonographic findings (p = 0.03), and presence of histological thyroiditis (p = 0.09) were independently associated with the occurrence of tumors with diameter greater than 2 cm. The percentage of transient and permanent postoperative complications were approximately 25 and below 2%, respectively. After a median follow-up time of 78.5 months, overall recurrence rate was 6.7% and disease-specific mortality was 1.2%., Conclusion: As US and FNAC did not consistently detect cancer in patients with diffuse multinodular goiter in our endemic area, evidence-based indications for surgery in this group of patients is needed, although radical surgery and favorable tumor histology offer favorable outcomes in commonly diagnosed thyroid cancer after total thyroidectomy for endemic multinodular goiter.
- Published
- 2012
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6. [When is thyroid fine-needle biopsy most effective?].
- Author
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Schmid KW and Reiners C
- Subjects
- Adult, Algorithms, Cross-Sectional Studies, Diagnosis, Differential, Germany, Goiter, Endemic diagnostic imaging, Goiter, Endemic epidemiology, Humans, Iodine deficiency, Practice Guidelines as Topic, Radionuclide Imaging, Thyroid Gland diagnostic imaging, Thyroid Neoplasms diagnostic imaging, Thyroid Neoplasms epidemiology, Thyroid Nodule diagnostic imaging, Thyroid Nodule epidemiology, Biopsy, Fine-Needle, Goiter, Endemic pathology, Thyroid Gland pathology, Thyroid Neoplasms pathology, Thyroid Nodule pathology
- Abstract
The essentially desirable standardisation of various European and American guidelines for the evaluation of thyroid nodules has led to the recommendation to perform fine-needle biopsy (FNB) in all nodules >1 cm in order to detect clinically occult thyroid carcinoma early. However, in iodine-deficient areas such as Germany (where thyroid nodules are found in approximately 25% of the adult population) this recommendation would substantially increase both the number of FNB and thyroid operations without significantly increasing the cancer detection rate. The recommendation for FNB in Germany, therefore, should be restricted to hypofunctioning ("cold") nodules >1 cm.
- Published
- 2011
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7. Routine ultrasound-guided aspiration cytology for evaluation of palpable thyroid nodules in an endemic area: is it justified?
- Author
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Muruganandham K, Sistla SC, Elangovan S, and Verma SK
- Subjects
- Adult, Endemic Diseases, Female, Goiter, Endemic diagnostic imaging, Goiter, Endemic epidemiology, Goiter, Endemic pathology, Goiter, Nodular diagnostic imaging, Goiter, Nodular epidemiology, Goiter, Nodular pathology, Humans, Male, Middle Aged, Palpation, Sensitivity and Specificity, Thyroid Neoplasms diagnostic imaging, Thyroid Neoplasms epidemiology, Thyroid Nodule diagnostic imaging, Thyroid Nodule epidemiology, Ultrasonography, Biopsy, Fine-Needle methods, Thyroid Neoplasms pathology, Thyroid Nodule pathology
- Abstract
Purpose: To prospectively evaluate the efficacy of routine ultrasound-guided fine-needle aspiration cytology (FNAC) of thyroid nodules in an endemic area and to analyze the factors influencing it., Methods: Patients with thyroid nodules were randomly subjected to either conventional palpation-guided fine-needle aspiration cytology (PFNAC) or ultrasound-guided fine-needle aspiration cytology (USFNAC). The results of cytology were compared with the final histopathologic diagnosis in 112 patients who had undergone surgery. The performance of both methods was individually analyzed in solid nodules, cystic nodules, and solitary and multinodular goitres., Results: Overall, USFNAC showed a significantly higher sensitivity (83.3% vs 54.6%, p < .001), positive predictive value (100% vs 85.7%, p < .001), and greater diagnostic accuracy (96.5% vs 89.1%, p = .052) compared with PFNAC. The sensitivity of USFNAC was significantly higher compared with that of PFNAC in cystic and complex nodules (75% vs 50%, p < .001) but not in solid nodules (77.8% vs 75%, p > .05). USFNAC was more sensitive and more accurate than PFNAC for detection of malignancy in multinodular goitres (66.7% vs 50%, p < .05; 95.6% vs 86.2%, p < .05, respectively)., Conclusion: The superiority of "routine" USFNAC over PFNAC is mainly due to its better performance in cystic nodules and multinodular goitres. Hence, routine USFNAC can be recommended in areas where such lesions constitute the majority of thyroid nodules.
- Published
- 2009
8. Standard-radical vs. function-preserving surgery of benign nodular goiter: a sonographic and biochemical 10-year follow-up study.
- Author
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Lehwald N, Cupisti K, Willenberg HS, Schott M, Krausch M, Raffel A, Wolf A, Brinkmann K, Eisenberger CF, and Knoefel WT
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Hyperthyroidism etiology, Hypothyroidism etiology, Male, Middle Aged, Postoperative Care, Postoperative Complications drug therapy, Postoperative Complications surgery, Recurrence, Reoperation, Ultrasonography, Goiter, Endemic diagnostic imaging, Goiter, Endemic surgery, Goiter, Nodular diagnostic imaging, Goiter, Nodular surgery, Postoperative Complications etiology, Thyroid Function Tests, Thyroidectomy methods, Thyroxine administration & dosage
- Abstract
Background: The necessary extent of thyroid resection in benign nodular goiter is under debate. The aim of our study was to compare the long-term outcome of different thyroid resection modes with special interest in the incidence of recurrent nodules and the use of oral thyroid hormone medication., Materials and Methods: We performed a follow-up examination of 109 patients (23 men and 86 women) having been operated for benign nodular goiter at our department 10 years ago. Unilateral resections and function-preserving resections of at least one thyroid lobe were classified as function-preserving (FP). Total thyroidectomy, Dunhill's operation and bilateral subtotal thyroidectomy were rated as standard-radical (STR). On follow-up, we recorded current oral thyroid hormone medication, thyroid function tests and ultrasound of the neck., Results: Seventy-three patients had FP resection (67%), while 36 were STR-operated (33%). The subsequent medical treatment was performed by dedicated endocrinologists (n = 19), internists (n = 11) or primary-care physicians (n = 59). Twenty patients had no medical attendance. Recurrent nodules were found in 13 cases in the FP group (18.6%) vs. 3 cases in the STR group (2.5%; p < 0.001). In both groups, about 80% of patients used thyroid hormone medication 10 years after operation., Conclusion: There was no advantage in thyroid function tests nor lesser medication in the FP group. The risk for recurrent nodules was significantly higher in the FP than in the STR-operated patients.
- Published
- 2009
- Full Text
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9. The Republic of Srpska Iodine Deficiency Survey 2006.
- Author
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Lolic A and Prodanovic N
- Subjects
- Bosnia and Herzegovina epidemiology, Child, Female, Goiter, Endemic diagnostic imaging, Goiter, Endemic urine, Humans, Iodine administration & dosage, Iodine supply & distribution, Iodine urine, Male, Palpation, Prevalence, Rural Population statistics & numerical data, Sodium Chloride, Dietary administration & dosage, Sodium Chloride, Dietary supply & distribution, Thyroid Gland diagnostic imaging, Thyroid Gland pathology, Ultrasonography, Urban Population statistics & numerical data, Goiter, Endemic epidemiology, Health Surveys, Iodine deficiency
- Abstract
Objective: A survey related to iodine deficiency in the Republic of Srpska was first conducted in 1999 and resulted in the adoption of regulations concerning the quality of salt for human consumption. In order to reassess iodine status, we conducted the Republic of Srpska Iodine Deficiency Survey in 2006., Design: The survey was conducted in a sample of 1,200 schoolchildren using parameters recommended by WHO, UNICEF and ICCIDD: palpation of thyroid gland, iodine urinary excretion, thyroid utrasonography and content of iodine in salt., Results: The goiter prevalence in the total group indicated mild iodine deficiency in the Republic of Srpska, whereas urinary iodine excretion suggested iodine sufficiency. Only 35.7% of salt samples were adequately iodinated, 51.2% were hypo-iodinated and 13.1% were hyper-iodinated. Of the salt samples tested, 40.9% were iodinated using potassium iodide, despite the fact that this method of salt iodination is forbidden by regulations related to the quality of salt for human consumption. Higher prevalence of goiter and lower urinary iodine content was found in rural areas compared to urban ones, although the iodine content of salt did not differ between these two areas., Conclusions: It seems that the Republic of Srpska has progressed from moderate (1999) to mild iodine deficiency with a wide range in the urinary iodine excretion values. However, the salt for human consumption is of low quality. The higher prevalence of goiter and the lower urinary iodine values in rural areas compared to urban ones may be attributed to differences in salt usage and/or nutritional factors.
- Published
- 2008
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10. Evaluation of goiter using ultrasound criteria: a survey in a middle schoolchildren population of a mountain area in Central Italy.
- Author
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Marino C, Martinelli M, Monacelli G, Stracci F, Stalteri D, Mastrandrea V, Puxeddu E, and Santeusanio F
- Subjects
- Adolescent, Child, Female, Goiter, Endemic pathology, Goiter, Endemic prevention & control, Health Surveys, Humans, Iodine therapeutic use, Iodine urine, Italy epidemiology, Male, Prevalence, Risk Factors, Sodium Chloride, Dietary therapeutic use, Thyroid Gland diagnostic imaging, Thyroid Gland pathology, Ultrasonography, Goiter, Endemic diagnostic imaging, Goiter, Endemic epidemiology, Population
- Abstract
Iodine deficiency is still an important health care problem in the world. In Italy, as in most European countries, it is responsible for the development of mild to moderate endemic goiter. In 1995 we conducted a goiter survey in the Gubbio township, an area of Umbria region in Italy, close to the Appenine mountain chain. This study demonstrated a high prevalence of goiter in the middle schoolchildren population, indicating the presence of moderate endemic goiter. Soon after, a goiter prevention campaign aimed at implementing the consumption of iodinated salt was started. In 2001, a second survey was conducted in the middle schoolchildren (age 11-14 yr old) of Gubbio and neighbour townships. Eight hundred thirteen subjects were studied. Data obtained in 240 age-matched children, studied in the same area in 1995, were used for comparison to monitor changes 5 yr after the beginning of iodine prophylaxis. Thyroid volume was measured by ultrasonography. Gland volume was expressed in ml. A large population living in a iodine-sufficient area, previously reported by others, was used as control. Urinary iodine excretion was measured randomly in 20% of the children. The overall prevalence of goiter decreased between 1995 and 2001 from 29 to 8%. Goiter odds ratio (OR), corrected for age, was 4.0 (95% CI 2.8-5.9) for 1995 compared to 2001 (p<0.000). Mean thyroid volume in the matched populations was 7.6+/-2.5 ml in 1995 and 5.7+/-2.1 ml in 2001. Median iodine urinary excretion increased from 72.6 to 93.5 mug/l, at the limit of statistical significance. Living in a rural area, no consumption of iodized salt and familiarity for goiter represented independent risk factors for goiter development. This study was the first conducted in Umbria region and confirmed that an implementation campaign for iodized salt consumption is a simple and useful instrument to prevent endemic goiter and related diseases. A new survey to evaluate goiter prevalence in the same area 10 yr after the beginning of iodine prophylaxis is already planned.
- Published
- 2006
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11. Iodine deficiency and goiter prevalence in Turkey after mandatory iodization.
- Author
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Cetin H, Kisioglu AN, Gursoy A, Bilaloglu E, and Ayata A
- Subjects
- Child, Cross-Sectional Studies, Female, Goiter diagnostic imaging, Goiter epidemiology, Goiter prevention & control, Goiter, Endemic diagnostic imaging, Humans, Iodine therapeutic use, Male, Prevalence, Thyroid Gland diagnostic imaging, Thyroid Gland pathology, Turkey epidemiology, Ultrasonography, Goiter, Endemic epidemiology, Goiter, Endemic prevention & control, Iodine deficiency, Sodium Chloride, Dietary therapeutic use
- Abstract
Objective: The determination of (a) iodine deficiency, and (b) the relation between the iodized salt consumption in the Isparta province of Turkey., Methods: Five hundred students between 6-11 yr of age were evaluated. With a questionnaire, the subjects were asked whether they were using iodine-containing salt or not. After their body weight and height were measured, thyroid glands were examined with palpation, thyroid volumes were determined with ultrasonography (USG), and urinary iodine concentration was analyzed., Results: The median urinary iodine concentration (UIC) of children was 7.00 microg/dl. This value reveals that Isparta is a region with mild iodine deficiency. The total goiter prevalence was 30.4% with palpation and 26% with USG. The goiter prevalence by ultrasonography was 14.2% for the urban and 36.2% for the rural areas. This difference was statistically significant (p<0.05). The rate of total iodized salt consumption was 68%, which was not a satisfactory level. The consumption of iodized salt in the urban areas was significantly higher than that in rural areas (74 vs 62%, p<0.05). The median UIC value was 10.00 microg/dl in urban areas compared to 5.00 microg/dl in rural areas., Conclusions: Our results indicate that although Isparta is a region with mild iodine deficiency, goiter prevalence remains a serious problem.
- Published
- 2006
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12. [To detect iodine deficiency goiter early. What does palpation bring?].
- Subjects
- Adolescent, Adult, Age Factors, Child, Female, Goiter, Endemic diagnostic imaging, Goiter, Nodular diagnosis, Goiter, Nodular diagnostic imaging, Humans, Male, Time Factors, Ultrasonography, World Health Organization, Goiter, Endemic diagnosis, Palpation
- Published
- 2006
13. [Every third employed person affected. Screening is federally worthwhile].
- Subjects
- Adolescent, Adult, Aged, Female, Germany epidemiology, Goiter, Endemic diagnostic imaging, Goiter, Endemic epidemiology, Goiter, Nodular diagnosis, Goiter, Nodular diagnostic imaging, Goiter, Nodular epidemiology, Humans, Male, Mass Screening, Middle Aged, Palpation, Sex Factors, Ultrasonography, Goiter, Endemic diagnosis
- Published
- 2006
14. Screening a coastal population in Southern Italy: iodine deficiency and prevalence of goitre, nutritional aspects and cardiovascular risk factors.
- Author
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Valentino R, Savastano S, Tommaselli AP, Di Biase S, Calvanese E, Carbone D, Dorato M, Orio F Jr, Lupoli G, and Lombardi G
- Subjects
- Adult, Aged, Female, Goiter diagnosis, Goiter diagnostic imaging, Goiter, Endemic diagnosis, Goiter, Endemic diagnostic imaging, Goiter, Endemic epidemiology, Humans, Italy epidemiology, Male, Middle Aged, Palpation, Prevalence, Risk Factors, Surveys and Questionnaires, Thyroid Gland diagnostic imaging, Ultrasonography, Cardiovascular Diseases epidemiology, Diet, Mediterranean, Goiter epidemiology, Iodine deficiency, Iodine urine, Mass Screening
- Abstract
Background and Aim: To evaluate the prevalence of goitre by means of urinary iodine excretion, palpatory and ultrasonographic thyroid examinations in a heterogeneous population living by the sea., Methods and Results: We used a special self-administered questionnaire to evaluate thyroid size, iodine intake, eating habits and cardiovascular risk factors in 600 subjects with a mean age of 45 +/- 17 years: 253 men (42.3%) and 347 women (57.7%). Urinary iodine excretion was low (72.1 +/- 15.7 microg/L; median 71.2) and associated with ultrasonographic evidence of an enlarged thyroid (16%) or structural thyroid abnormalities (30%), thus allowing us to define the Salerno Gulf as a mild-moderate area of endemic goitre. All of the subjects ate a Mediterranean diet, with a mean of two portions of fish/week. The cardiovascular risk factors considered were obesity, cigarette smoking, hypertension, hypercholesterolemia, hypertriglyceridemia and diabetes, the prevalences of which were in line with those reported in other studies of similar age-matched populations., Conclusions: The moderate intake of fish and the consumption of a Mediterranean diet did not prevent goitre. Iodine deficiency and subsequent goitre endemia are also present at sea level, probably because of a diet based on local products grown on soil with a low iodine content or possible seawater, soil and air environmental pollution that may interfere with the availability of iodine. The assessment of iodine deficiency should therefore involve the entire population and not only subjects living far from the sea.
- Published
- 2004
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15. Prevalence of antithyroid microsomal antibody in thyroid patients of endemic goitre area.
- Author
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Mahmood S, Islam MM, Siddiqui NI, Hossain GA, Chakraborty RK, Akhter N, and Meah I
- Subjects
- Adolescent, Adult, Antibody Specificity immunology, Autoantibodies blood, Bangladesh epidemiology, Child, Female, Goiter, Endemic diagnostic imaging, Goiter, Endemic epidemiology, Humans, Iodine deficiency, Male, Middle Aged, Prevalence, Radioimmunoassay, Radionuclide Imaging, Thyroiditis, Autoimmune diagnostic imaging, Thyroiditis, Autoimmune epidemiology, Autoantibodies immunology, Goiter, Endemic immunology, Thyroiditis, Autoimmune immunology
- Abstract
The region of greater Mymensingh known for iodine endemicity, recently came under iodine supplementation as a result of mandatory universal iodination of salt program. Autoimmune thyroid diseases (AITD) are among the most common human autoimmune disorders & presence of autoantibodies to the microsomal antigen (AntiMCAb) is a hallmark of disease activity. Both iodine deficiency & iodine supplementation precipitate increase rate of autoimmunity to the thyroid gland. Study was undertaken to determine prevalence of AntiMCAb positive cases among patients with various thyroid diseases. High resolution ultrasound (HRUS), serum thyroid hormone assays & scintiscan were used to classify the thyroid patients into 8 categories. 221 patients were studied during the stipulated period of 3 months. Male patients were 60 & female patients were 161. Age ranged from 11 to 65 years with median age 29.4 years. AntiMCAb test were done with radioimmunoassay (RIA). 126 patients had antimicrosomal antibody (57.01%). All form of hypothyroid (atrophic, goitrous, Hashimoto's) have very high rate of AntiMCAb positive cases. Highest 89.28% were seen in patients showing feature of Hashimoto's thyroiditis or generalized feature of AITD in HRUS with hypothyroidism, followed had 61.29% positive cases, However, antithyroid antibody was found in all form of thyroid disorders. Nodular goiter had 21.73% antiMCAb positive cases. AntiMCAb found positive at the rate of 33.33% in euthyroid patients with HRUS feature of AITD & diffuse euthyroid goiter, 40% in subclinical hypothyroid, 40% in subclinical hyperthyroid. Female rated higher in range of antimicrosomal antibody positivism. 59% of all thyroid patients among female subjects were AntMCAb positive, where as 51.67% male thyroid patients were positive. Highest number of positive cases found in the 30-35 age group. No definite pattern, however, was observed among age distribution. 20 age matched sample from patients unsuspected of thyroid disease shows 10% AntiMCAb positive compared to 73.33% of the same among same age group of thyroid patients. Frank Hashimoto's thyroiditis with positive antiMCAb and hypothyroidism were all detected by HRUS.
- Published
- 2004
16. Assessment of goiter prevalence, iodine status and thyroid functions in school-age children of rural Yusufeli district in eastern Turkey.
- Author
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Ozkan B, Olgun H, Ceviz N, Polat P, Taysi S, Orbak Z, and Koşan C
- Subjects
- Child, Female, Goiter, Endemic diagnostic imaging, Health Promotion, Humans, Iodine therapeutic use, Iodine urine, Male, Prevalence, Surveys and Questionnaires, Thyroid Function Tests, Thyrotropin blood, Turkey epidemiology, Ultrasonography, Goiter, Endemic epidemiology, Iodine deficiency
- Abstract
According to previous studies, Turkey has generally been accepted as a moderate endemic iodine deficient country. However, it has recently been reported that there are regions in Turkey where iodine deficiency is more severe than previously known. The current study was aimed at ascertaining the goiter prevalence by thyroid volumes, iodine status and thyroid functions in school-age children living in an area which is suspected to have moderate or severe iodine deficiency. Overall goiter was found in 47.6% of children, in 22.8% of girls and in 24.8% of boys. Mean thyroid volumes did not differ significantly according to sex. Significant correlation was found between thyroid volume and body surface area and age. There was a negative correlation between the urinary iodine concentration and thyroid volume (r = 0.45, p < 0.01). Median urinary iodine concentrations in subjects with and without goiter were 20 microg/dl and 5.2 microg/dl, respectively. While median urinary iodine levels of the subjects with goiter were consistent with severe-moderate iodine deficiency, levels in subjects without goiter were comparable to moderate-mild iodine deficiency. None of the subjects had the signs or symptoms of hyper-or hypothyroidism. The differences in the mean values of thyroid hormones and TSH levels between subjects with or without goiter were not significant (p > 0.05). No correlation was found between urinary iodine concentrations and thyroid hormone levels. A weak correlation was found between urinary iodine concentration and TSH levels (r = 0.12, p = 0.05). Individuals with goiter were investigated etiologically: biochemical hypothyroidism was detected in 2%, compensated hypothyroidism in 12.6%, autoimmune thyroiditis in 2%, nodular goiter in 3% and isolated high TSH level with autoimmune thyroiditis in 0.08%. In conclusion, although a salt iodization program has been started in Turkey, our study indicates that some regions with severe iodine deficiency are still present. This research suggests that this program should be re-evaluated for remote areas with self-contained economic systems, and should be expanded and more effectively applied nation-wide.
- Published
- 2004
17. [Thyroid gland ultrasound screening (Papillon Initiative). Report of 15 incidentally detected thyroid cancers].
- Author
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Reiners C, Schumm-Draeger PM, Geling M, Mastbaum C, Schönberger J, Laue-Savic A, Hackethal K, Hampel R, Heinken U, Kullak W, Linke R, and Uhde W
- Subjects
- Adolescent, Adult, Age Factors, Aged, Biopsy, Needle, Cross-Sectional Studies, Female, Goiter, Endemic epidemiology, Goiter, Endemic pathology, Goiter, Nodular epidemiology, Goiter, Nodular pathology, Humans, Incidental Findings, Male, Middle Aged, Neoplasm Staging, Occupational Health Services statistics & numerical data, Reproducibility of Results, Sex Factors, Thyroid Gland diagnostic imaging, Thyroid Gland pathology, Thyroid Neoplasms epidemiology, Thyroid Neoplasms pathology, Thyroid Nodule epidemiology, Thyroid Nodule pathology, Thyroid Nodule surgery, Ultrasonography, Goiter, Endemic diagnostic imaging, Goiter, Nodular diagnostic imaging, Mass Screening statistics & numerical data, Thyroid Neoplasms diagnostic imaging, Thyroid Nodule diagnostic imaging
- Abstract
In the framework of the Thyroid initiative Papillon 2001 - 2002 thyroid nodules and sonographically detectable focal lesions with a diameter more than 5 mm were verified in 23.1% of 64.123 persons without a history of thyroid disease. The frequency of such findings was with 33.0% in 46-65 years old persons three times higher then in persons aged 18-30 years (9.6%). In the diagnostic workup thyroid cancer was detected in 15 patients operated on up to now (6 women and 9 men; papillary cancers in 12 cases, follicular cancers in 3 cases) The smallest tumor had a diameter of 1.3 cm, the mean diameter was 2.3 +/- 91 cm. In 3 patients the tumor had invaded the tissue beyond the thyroid capsule, in 4 cases multicentric growth was detected. Lymph node metastases were found in 7/15 cases and distant metastases in 2/15 cases. These result reveal, that thyroid cancer detected by chance may be relatively aggressive. In daily routine, sonographically detectable lesions with poor echogenicity, irregular margins or internal calcifications with a diameter of more than 1 cm should be clarified by fine needle aspiration biopsy.
- Published
- 2003
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18. Impact of localization studies on feasibility of minimally invasive parathyroidectomy in an endemic goiter region.
- Author
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Prager G, Czerny C, Ofluoglu S, Kurtaran A, Passler C, Kaczirek K, Scheuba C, and Niederle B
- Subjects
- Adenoma blood, Adenoma diagnostic imaging, Adenoma pathology, Adenoma surgery, Adult, Aged, Aged, 80 and over, Endoscopy, Feasibility Studies, Female, Goiter, Endemic blood, Goiter, Endemic diagnostic imaging, Goiter, Endemic pathology, Humans, Male, Middle Aged, Minimally Invasive Surgical Procedures, Monitoring, Intraoperative, Parathyroid Glands diagnostic imaging, Parathyroid Glands pathology, Parathyroid Glands surgery, Parathyroid Hormone blood, Parathyroid Neoplasms blood, Parathyroid Neoplasms diagnostic imaging, Parathyroid Neoplasms pathology, Prospective Studies, Radiopharmaceuticals, Technetium Tc 99m Sestamibi, Tomography, Emission-Computed, Single-Photon, Ultrasonography, Doppler, Color, Video-Assisted Surgery, Goiter, Endemic surgery, Parathyroid Neoplasms surgery, Parathyroidectomy methods
- Abstract
Background: A localized single-gland disease is the basis for minimally invasive parathyroidectomy (MIP) in primary hyperparathyroidism (PHPT). (99m)Tc sestamibi scanning (MIBI) and high-resolution Doppler ultrasonography (US) are well-established techniques used to localize enlarged parathyroid glands. Additionally, US enables physicians to diagnose subclinical thyroid abnormalities. The aim of this study was to optimize localization results, applying a combined interpretation of MIBI and US, and to analyze the influence of these results on the feasibility of MIP (endoscopic/video-assisted and open) in an endemic goiter region., Study Design: One hundred fifty consecutive patients with sporadic PHPT were prospectively subjected to MIBI and US to localize parathyroid lesions and to review the morphology of the thyroid gland. Bilateral cervical exploration was performed in all patients. The feasibility of MIP was calculated retrospectively on the basis of surgical findings and biochemical outcomes at least 12 months postoperatively (normocalcemia in 148 of 150 patients [99%])., Results: Forty-five percent of patients (67 of 148) would have been suitable for minimally invasive endoscopic or video-assisted parathyroid exploration. These procedures would have succeeded in 38% of patients (56 of 148). Sixty-four percent (94 of 148) would have been suitable for minimally invasive open parathyroidectomy, which would have succeeded in 55% (82 of 148 patients)., Conclusions: Not all patients are suitable for MIP. A combined interpretation of MIBI and US results is helpful in planning targeted exploration. In an endemic goiter region minimally invasive open parathyroidectomy is applicable in significantly more patients than is endoscopic and video-assisted MIP.
- Published
- 2003
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19. Endemic goiter in pregnant women: utility of the simplified classification of thyroid size by palpation and urinary iodine as screening tests.
- Author
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Castañeda R, Lechuga D, Ramos RI, Magos C, Orozco M, and Martínez H
- Subjects
- Adult, Female, Goiter, Endemic diagnostic imaging, Goiter, Endemic urine, Humans, Mass Screening, Palpation methods, Pregnancy, Pregnancy Complications diagnostic imaging, Pregnancy Complications urine, Risk Factors, Sensitivity and Specificity, Thyroid Gland diagnostic imaging, Ultrasonography, Prenatal methods, Goiter, Endemic pathology, Iodine urine, Pregnancy Complications pathology, Thyroid Gland pathology
- Abstract
Objective: To validate urinary iodine (I) excretion and the simplified classification of goiter by palpation, comparing them with ultrasound of the thyroid gland as the gold standard, to identify endemic goiter in pregnant women., Population and Setting: 300 pregnant women identified in referral hospitals, in three geographic regions., Methods: Two endocrinologists, previously trained, evaluated thyroid size by palpation and by ultrasound. Urinary iodine excretion in a sample of urine was determined. Thyroid size below the 90th centile by ultrasound was considered normal., Results: Mean age of study women was 23 years old. The prevalence of low weight for gestational age was 39% and of anaemia 47%. Our sample distribution showed that 120 microg I/L was the best cut off for low urinary iodine excretion to identify endemic goiter in pregnant women (sensitivity 57% and specificity 70%, likelihood ratio of 1.4). The prevalence of goiter was 10% using ultrasound. Palpation had a sensitivity of identification goiter of 94% (95% CI 89-99%), a specificity of 80% (95% CI 75-85%), a likelihood ratio of 4.7, positive post-test probability of 36.5% and negative post-test probability of 99%., Conclusions: Low urinary iodine excretion identified up to 46% of women with goiter. This test by itself is not useful as a screening tool to identify pregnant women at risk of goiter. Identification of thyroid size by palpation was a better screening test. However, when both tests were combined in parallel, up to 100% of women with goiter were correctly identified. Our results suggest that the commonly used cut off point of 100 microg I/L to identify low urinary iodine excretion may under-estimate the prevalence of iodine deficiency disorders when used during pregnancy.
- Published
- 2002
20. [Monitoring of iodine in The Child and Adolescent Health Survey].
- Author
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Dippelhofer A, Thamm M, and Thierfelder W
- Subjects
- Adolescent, Child, Child, Preschool, Cross-Sectional Studies, Female, Germany, Goiter, Endemic diagnostic imaging, Goiter, Endemic urine, Health Surveys, Humans, Infant, Iodine urine, Male, Pilot Projects, Reference Values, Ultrasonography, Goiter, Endemic epidemiology, Health Status Indicators, Iodine deficiency
- Abstract
In the first quarter of 2003 a National Health Survey for Children and Adolescents will be started and carried out over a period of three years. In 11,300 children and adolescents between 6 and 18 years a comprehensive iodine monitoring will be realised. The volume of the thyroid gland will be determined sonographically, thyroid hormones and the urinary iodine excretion will be measured. Apart from the nutritional intake of iodine and the use of supplements, socio-demographic and other variables relevant to health will be recorded in a self-administered questionnaire. In the pilot study of the Health Survey for Children and Adolescents from March 2001 to March 2002 the method was tested on 426 children and adolescents and has proved feasible. The sample for the pretest was not representative for the population of children and adolescents in Germany but may already be an indication for the iodine supply. A low goitre prevalence of 4.2% was found. The total thyroid volume correlated significantly with height and weight. There was no significant difference between boys and girls or between a rural and an urban sample point.
- Published
- 2002
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21. [Comparative study with 2 L-thyroxine-iodide combinations. Iodine deficient goiter can be decreased also with less thyroxine].
- Author
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Hotze LA and Wegscheider K
- Subjects
- Adolescent, Adult, Aged, Dose-Response Relationship, Drug, Drug Combinations, Female, Germany, Goiter, Endemic diagnostic imaging, Humans, Infant, Newborn, Male, Middle Aged, Prospective Studies, Randomized Controlled Trials as Topic, Thyroid Function Tests, Treatment Outcome, Ultrasonography, Goiter, Endemic drug therapy, Iodine administration & dosage, Thyroxine administration & dosage
- Published
- 2002
22. [Goiter and nodules in the thyroid gland. 15 million patients with undetected illness].
- Subjects
- Cross-Sectional Studies, Germany epidemiology, Goiter, Endemic diagnostic imaging, Goiter, Nodular diagnostic imaging, Humans, Incidence, Ultrasonography, Goiter, Endemic epidemiology, Goiter, Nodular epidemiology, Mass Screening
- Published
- 2002
23. [The study of iodine sufficiency in children of Kiev].
- Author
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Kravchenko VI, Tron'ko MD, Mel'nychenko VM, Turchyn VI, Luzanchuk IA, Tkachuk LA, and Shabliĭ OV
- Subjects
- Adolescent, Child, Female, Goiter, Endemic epidemiology, Goiter, Endemic metabolism, Humans, Iodine urine, Male, Thyroid Gland metabolism, Ukraine epidemiology, Ultrasonography, Goiter, Endemic diagnostic imaging, Iodine deficiency, Thyroid Gland diagnostic imaging
- Abstract
A total of 576 pupils in different age groups of a school in Kiev were examined. Determined in the above pupils by palpation and echography were sizes of the thyroid gland, urine excretion of iodine. Thyroid enlargement was identified in nearly 30 percent of the examined children, nodal pathology of the gland was in 0.52 percent. It was only in 34 percent of the examinees that the level of iodine excretion was more than 100 mcgrm/l, i.e. did not deviate from the norm; 5.3% of children had ioduria indices < 20 mcgrm/l, which observation suggested a severe iodine deficiency. In the major proportion of children the level of ioduria ranged from 50 up to 100 mcgrm/l, the median value for the group of children as a whole came up to 62.9 mcgrm/l. According to results of the studies made on goiter rates among children and on the level of urine excretion of iodine, the population are in want of bodily iodine, and Kiev falls in to a zone of mild iodine deficiency.
- Published
- 2002
24. Minimally invasive open parathyroidectomy in an endemic goiter area: a prospective study.
- Author
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Prager G, Czerny C, Kurtaran A, Passler C, Scheuba C, Bieglmayer C, and Niederle B
- Subjects
- Adolescent, Adult, Aged, Algorithms, Female, Goiter, Endemic blood, Goiter, Endemic diagnostic imaging, Goiter, Endemic pathology, Humans, Male, Middle Aged, Minimally Invasive Surgical Procedures, Monitoring, Intraoperative, Parathyroid Glands diagnostic imaging, Parathyroid Glands pathology, Parathyroid Glands surgery, Patient Selection, Prospective Studies, Radiopharmaceuticals, Technetium Tc 99m Sestamibi, Tomography, Emission-Computed, Single-Photon, Ultrasonography, Doppler, Color, Goiter, Endemic surgery, Parathyroid Hormone blood, Parathyroidectomy methods
- Abstract
Hypothesis: Single-gland disease identified by preoperative localization studies in combination with rapid intraoperative parathyroid hormone monitoring seems to allow a limited exploration of the neck in sporadic primary hyperparathyroidism. Minimally invasive open parathyroidectomy by lateral approach (oMIP) in sporadic primary hyperparathyroidism seems feasible in an endemic goiter region., Design: One hundred consecutive patients with sporadic primary hyperparathyroidism underwent preoperative double-phase technetium Tc 99m sestamibi scanning with single-photon emission computed tomography and high-resolution ultrasonography with color Doppler imaging of the cervical region. All patients were operated on with the use of quick parathyroid hormone assay to confirm the surgical success "on-line." Patients with localized single-gland disease, irrespective of additional ipsilateral thyroid disease requiring surgery, were selected for oMIP. Success of the preoperative localization studies, postoperative (at least 6 months) serum calcium levels, and operating time were analyzed., Setting: University hospital, section of endocrine surgery., Results: Of 100 patients, 83 (83%) were considered suitable for oMIP. In 69 patients, oMIP was finished successfully. Nine of these had had previous neck surgery, and another 24 underwent additional ipsilateral thyroid resection. Permanent normocalcemia was achieved in 67 (97.1%) of 69 patients and 98 (98%) of 100 patients., Conclusion: The oMIP in combination with quick parathyroid hormone assay may become the treatment of choice for sporadic primary hyperparathyroidism in an endemic goiter region in centers with high experience in thyroid and parathyroid surgery. It allows treatment of concomitant ipsilateral thyroid disease and is feasible in reoperations.
- Published
- 2001
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25. [Comparison of the effectiveness of two different dosages of levothyroxine-iodide combinations for the therapy of euthyroid diffuse goiter].
- Author
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Kreissl M, Tiemann M, Hänscheid H, Rendl J, and Reiners C
- Subjects
- Adult, Drug Combinations, Drug Therapy, Combination, Female, Germany, Goiter, Endemic blood, Goiter, Endemic diagnostic imaging, Humans, Iodides administration & dosage, Iodine analysis, Prospective Studies, Thyroid Gland diagnostic imaging, Thyroid Gland drug effects, Thyroid Gland metabolism, Thyroid Hormones blood, Thyrotropin blood, Thyrotropin drug effects, Thyroxine administration & dosage, Thyroxine adverse effects, Ultrasonography, Goiter, Endemic drug therapy, Iodides therapeutic use, Iodine deficiency, Thyroxine therapeutic use
- Abstract
Background and Objective: Administration of levothyroxine and/or iodide can effectively reduce the volume of endemic goitre. However, TSH suppression during levothyroxine treatment may increase the number of recurrences through the persistence of intrathyroidal iodine deficiency. With special attention paid to the level of levothyroxine, a comparison was made of two dosages of combined levothyroxine and iodide., Patients and Methods: 44 patients with diffuse euthyroid goitre were randomized to two treatment groups. Group A received 100 micrograms levothyroxine + 100 micrograms iodide, group B 75 micrograms levothyroxine + 150 micrograms iodide, all of them for three months. This was followed by three months without the medication. Intrathyroidal iodine concentration was measured at the onset of the study, then three months and six months later. At these same times thyroid volume was measured by ultrasound, as well as urinary iodine and various parameters of thyroid function., Results: Thyroid gland volume was reduced in both groups (group A: -17.3%; group B: -14.8%; p < 0.001). There was no significant difference of intrathyroidal iodine concentration and thyroid volume between both groups. After the treatment period, TSH suppression was more marked in group A, while TSH rise was greater in group B., Conclusions: Both drug combinations resulted in comparable reduction of thyroid volume, while the intrathyroid concentration of iodine remained unchanged. The smaller rise of TSH after the treatment suggests that the dosage of 75 micrograms levothyroxine + 150 micrograms iodine is to be preferred.
- Published
- 2001
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26. Classification of thyroid size by palpation and ultrasonography in field surveys.
- Author
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Peterson S, Sanga A, Eklöf H, Bunga B, Taube A, Gebre-Medhin M, and Rosling H
- Subjects
- Adolescent, Child, Female, Goiter, Endemic epidemiology, Humans, Male, Prevalence, Sensitivity and Specificity, Tanzania epidemiology, Ultrasonography, Goiter, Endemic classification, Goiter, Endemic diagnostic imaging, Palpation, Thyroid Gland diagnostic imaging
- Abstract
Background: Goitre surveys are used to assess the degree of iodine deficiency in a population. The change of goitre classification made by WHO in 1994 implied that a smaller thyroid size should be regarded as goitre. Furthermore, the acceptable goitre prevalence was lowered from 10% to 5%, and ultrasonography was recommended as a more precise method for diagnosis of goitre. We studied the effects of the change of palpation system, and compared the precision of the old and new systems with that of ultrasonographic examination., Methods: We studied 225 schoolchildren (aged 7-14 years) in a highland village in Tanzania. The size of the thyroid was assessed in duplicate by ultrasonography and by WHO's 1960 and 1994 palpation systems. The latter were done by three examiners. Variations within and between examination methods and examiners were assessed, and measurement errors by ultrasonography were assessed from duplicate examinations. The sensitivity and specificity of the two palpation systems were calculated, with diagnosis by ultrasonography as the gold standard. Apparent palpation prevalences were calculated at a "true" 5% prevalence., Findings: The lowered criterion for goitre resulted in an extra 20-33% of children being diagnosed as having goitre by palpation. The variation between repeat examinations was only slightly smaller by ultrasonography (kappa=0.63) than by experienced examiners (kappa=0.57-0.58). The variation between thyroid volume estimation by ultrasonography and the true volume was about 50% due to both measurement error and variation in the shape of thyroid lobes. The new goitre criterion decreased specificity from 76% to 29%, whereas sensitivity rose from 56% to 80%. In contrast, a suggested sharpening of the old criterion increased specificity to 90%., Interpretation: A return to the old (1960) palpation criterion for goitre: "lobes larger than the terminal phalanxes of thumbs" and to an accepted palpation goitre prevalence of 10% can allow affordable monitoring of thyroid size through palpation in field surveys.
- Published
- 2000
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27. Relationship between intrathyroid calcifications and thyroglobulin in endemic goiter.
- Author
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Zaccheroni V, Iagulli MP, Vescini F, Bianchi GP, Menini S, Vacirca A, Vallese M, and Lodi A
- Subjects
- Adult, Aged, Aged, 80 and over, Calcinosis diagnostic imaging, Calcinosis pathology, Female, Goiter, Endemic diagnostic imaging, Goiter, Endemic pathology, Humans, Male, Middle Aged, Thyroid Gland diagnostic imaging, Thyroid Neoplasms diagnostic imaging, Thyroid Neoplasms metabolism, Thyroid Neoplasms pathology, Ultrasonography, Calcinosis metabolism, Goiter, Endemic metabolism, Thyroglobulin metabolism, Thyroid Gland metabolism
- Abstract
Intrathyroid calcifications represent a common finding within simple or nodular goiters, but, as far as they can be found also inside papillary and medullary thyroid carcinomas, an ultrasonographic detection of intrathyroid calcifications stands as a different diagnosis problem. We have been looking for the presence of parameters associated with thyroid calcifications in patients affected by simple or nodular goiter, either sporadic or endemic. We studied 284 euthyroid subjects, 250 females, ageing from 24 to 90 years, affected by a simple goiter, in the 9.51% of the cases, and by a nodular goiter in the remaining part. 69.37% of the patients came from an endemic goiter area, while the others were affected by sporadic goiter. We tested fT3, fT4, TSH, hTG, Ab-TG, Ab-TPO and performed an ultrasonography in all the subjects, 57.75% of patients shown intrathyroid calcifications in the 57.75% of them. We applied a multistep discriminant analysis taking for the presence/absence of calcifications as dependent variable and we tried to find which variable, by itself or in combination with others, could foretell its presence. We also created a new variable (TG1) to differentiate normal from supraphysiologic concentrations of hTG (< 60 ng/ml). The variable with the highest significance F originated from endemic goiter area (F = 96.36), followed by TG1 (F = 24.46) and age (F = 10.61). On the contrary hTG did not relate to calcifications, due to non-proportionally direct relationship between these two parameters, afterwards we used the multistep logistic regression that gave overlapping significances. This means that supraphysiologic hTG rates are sufficient to predict the possible presence of intrathyroid calcifications. In conclusion, as far as a follicular hyperstimulation can be assumed, especially if long-lasting, the presence of intrathyroid calcifications should rise a clinical suspect toward an old goiter rather than a neoplastic lesion.
- Published
- 1999
28. Iodide induces thyroid autoimmunity in patients with endemic goitre: a randomised, double-blind, placebo-controlled trial.
- Author
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Kahaly GJ, Dienes HP, Beyer J, and Hommel G
- Subjects
- Adult, Double-Blind Method, Female, Goiter, Endemic diagnostic imaging, Goiter, Endemic drug therapy, Humans, Iodides therapeutic use, Iodides urine, Male, Middle Aged, Thyroid Gland diagnostic imaging, Thyroid Gland pathology, Thyroiditis, Autoimmune diagnostic imaging, Thyroiditis, Autoimmune pathology, Thyroxine therapeutic use, Ultrasonography, Goiter, Endemic complications, Iodides adverse effects, Thyroiditis, Autoimmune chemically induced
- Abstract
Objective: Iodine is essential for normal thyroid function and the majority of individuals tolerate a wide range of dietary levels. However, a subset of individuals, on exposure to iodine, develop thyroid dysfunction. In this double-blind trial, we evaluated the efficacy and tolerability of low-dose iodine compared with those of levo-thyroxine (T4) in patients with endemic goitre., Methods: Sixty-two patients were assigned randomly to groups to receive iodine (0.5 mg/day) or T4 (0.125 mg/day) for 6 months. Subsequently, both groups were subject to placebo for another 6 months. Thyroid sonography, determination of thyroid-related hormones and antibodies, and urinary excretion of iodine were carried out at baseline and at 1, 6 and 12 months., Results: At 6 months, markedly increased urinary values of iodine were found in patients receiving iodine (36 microg/24 h at baseline, 415 microg/24 h at 6 months) compared with those receiving T4 (47 microg/ 24 h at baseline, 165 microg/24 h at 6 months; P < 0.0001 compared with iodine group). T4 administration engendered a greater (P < 0.01) decrease in thyroid volume (from 32 ml to 17 ml, P < 0.0001) than did intake of iodine (3 3 ml to 21 ml. P < 0.005). High microsomal and thyroglobulin autoantibody titres were present in six of 31 patients (19%) receiving iodine, and iodine-induced hypo- and hyperthyroidism developed in four and two of them, respectively. Fine-needle biopsy revealed marked lymphocyte infiltration in all six. After withdrawal of iodine thyroid dysfunction remitted spontaneously and antibody titres and lymphocyte infiltration decreased markedly. Follow-up of these six patients for an additional 3 years showed normalisation of antibody titres in four of them., Conclusion: Although nearly comparable results were obtained with both treatment regimens regarding thyroid size, partly reversible iodine-induced thyroid dysfunction and autoimmunity were observed among patients with endemic goitre.
- Published
- 1998
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29. [Individually dosed levothyroxine with 150 micrograms iodide versus 100 micrograms levothyroxine combined with 100 micrograms iodide. A randomized double-blind trial].
- Author
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Förster G, Krummenauer F, Hansen C, Beyer J, and Kahaly G
- Subjects
- Adult, Double-Blind Method, Drug Combinations, Drug Therapy, Combination, Female, Goiter, Endemic blood, Goiter, Endemic diagnostic imaging, Humans, Iodides adverse effects, Male, Prospective Studies, Thyroid Gland diagnostic imaging, Thyroid Hormones blood, Thyrotropin blood, Thyroxine adverse effects, Time Factors, Ultrasonography, Goiter, Endemic drug therapy, Iodides administration & dosage, Thyroxine administration & dosage
- Abstract
Basic Problem and Objective: Intrathyroid deficiency and the influence of thyroid stimulating hormone (TSH) are the main pathogenetic factors in the development of endemic euthyroid goitre. Goitre reduction is achieved with either administration of levothyroxine, which diminishes hypophyseal TSG production, or of iodide. Aim of this study was to compare the efficacy of treatment with a dose-fixed combination of levothyroxine plus iodide with that of an individualized dosage of levothyroxine plus iodide., Patients and Methods: After randomization 49 patients with euthyroid goitre (24 women, 25 men, aged 20-43 years) were treated for 12 weeks in a double-blind trial. Patients in group A received levothyroxine in a weight-adapted dosage (75,100 or 150 micrograms) plus 150 micrograms iodide, while those in group B were given a fixed dosage of 100 micrograms levothyroxine plus 100 micrograms iodide. Basal TSH, thyroid hormones, iodide excretion, hyperthyroid score and sonographic volume of the thyroid were determined before treatment and after 12 weeks., Results: Basal TSH levels were reduced in both groups (P < 0.0001), without significant difference between the two groups (median relative change: group A 78.1%, group B 52.8%). Thyroid volume was decreased independently of the form of treatment (P < 0.0001) (median relative reduction: group A 37.6%, group B 30.9%; difference not significant). Iodide excretion rose in both groups, without significant difference (group A 107%, group B 49%). There was hardly any change of the hyperthyroid score in both groups. There were no side effects., Conclusion: Both forms of medication were equally efficacious and well tolerated in the treatment of euthyroid goitre.
- Published
- 1998
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30. [Epidemiologic investigation on the prevalence of goiter and urinary excretion of iodine in the school population of the province of Reggio Emilia].
- Author
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Zini M, Poluzzi V, Bertani A, Portioli I, Cavalchi B, and Valcavi R
- Subjects
- Adolescent, Biomarkers urine, Child, Female, Goiter, Endemic diagnostic imaging, Goiter, Endemic urine, Health Surveys, Humans, Iodine deficiency, Iodine urine, Italy epidemiology, Male, Palpation, Thyroid Gland diagnostic imaging, Topography, Medical, Ultrasonography, Goiter, Endemic epidemiology
- Abstract
The prevalence of goiter was evaluated in a sample from the schoolchildren population of Reggio Emilia district. 1020 children underwent physical examination of thyroid gland and thyroid ultrasonography for determination of thyroid volume. Urinary iodine excretion (UIE) was measured in 837/1020 (82.1%). Iodine content was measured in water samples collected from 65 wells and 12 springs all around the district. The prevalence of goiter according to thyroid gland palpation was 26.2%. Thyroid volume was 4.74 +/- 1.87 ml, and the median UIE value 85 micrograms/l. According to the UIE classes as defined by WHO, 57.8% of all subjects showed a UIE less than 100 micrograms/l. In 57 out of 65 wells and in all the 12 springs examined, iodine was completely absent. In the remaining 8 wells, only iodine traces were found. Based on the results of physical examination of the thyroid gland, Reggio Emilia district should be regarded as an endemic goiter area. Nevertheless, thyroid volume measurement by ultrasound indicates that goiter prevalence may be markedly overestimated by palpation. The high prevalence of subjects featuring an increased thyroid volume, the low median UIE value and the poor iodine content in the local reservoirs of drinkable water suggest the opportunity for iodine prophylaxis in the Reggio Emilia district.
- Published
- 1998
31. [Screening for thyroid diseases by using ultrasound scanners].
- Author
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Proshin AD, Dorokhov VV, Doroshchenko VN, and Podgurskiĭ IB
- Subjects
- Adolescent, Age Factors, Child, Goiter diagnostic imaging, Goiter prevention & control, Goiter, Endemic diagnostic imaging, Goiter, Endemic prevention & control, Goiter, Nodular diagnostic imaging, Goiter, Nodular prevention & control, Humans, Mass Screening, Power Plants, Radioactive Hazard Release, Risk Factors, Russia, Thyroid Diseases prevention & control, Thyroiditis, Autoimmune diagnostic imaging, Thyroiditis, Autoimmune prevention & control, Ukraine, Ultrasonography, Thyroid Diseases diagnostic imaging
- Published
- 1998
32. [Widespread endemic goiter and iodine deficiency in the province of Avellino].
- Author
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Pagliara S, Spagnuolo E, D'Avanzo A, Vitale M, Macchia PE, Salvatore D, Ramundo V, Ciasullo M, Macchia V, and Fenzi G
- Subjects
- Adolescent, Adult, Biomarkers urine, Child, Female, Goiter, Endemic diagnostic imaging, Health Surveys, Humans, Italy epidemiology, Male, Prevalence, Thyroid Gland diagnostic imaging, Ultrasonography, Goiter, Endemic epidemiology, Iodine deficiency
- Abstract
1352 schoolchildren between 6-14 years old (699 males and 653 females) and 943 adults (176 males and 767 females) from eight villages of the province of Avellino were studied. All subjects were examined for thyroid size by at least two expert examiners. In most of them urine samples were collected for iodine determinations. 387 schoolchildren and 161 adults from Flumeri and Villanova were evaluated by thyroid echography. The prevalence of goiter was from 23.5 to 52.2% and the median urinary iodine excretion was from 42.3 to 66.2 micrograms/l in schoolchildren. In adults the prevalence of goiter was from 41.2 to 86.7% and the median urinary iodine excretion was from 37.1 to 53.7 micrograms/l. Our data showed a degree of iodine deficiency from low to moderate. The echography permitted to point out a greater prevalence of nodules than the thyroid palpation.
- Published
- 1998
33. [Treatment of euthyroid struma. Comparable volume reduction with 400 micrograms iodine, 100 micrograms levothyroxine combined with 100 micrograms iodine or individually dosed levothyroxine].
- Author
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Peters H, Hackel D, and Schleusener H
- Subjects
- Adult, Dose-Response Relationship, Drug, Drug Therapy, Combination, Euthyroid Sick Syndromes diagnostic imaging, Female, Goiter, Endemic diagnostic imaging, Humans, Male, Prospective Studies, Thyroid Function Tests, Thyroid Gland diagnostic imaging, Thyroid Gland drug effects, Treatment Outcome, Ultrasonography, Euthyroid Sick Syndromes drug therapy, Goiter, Endemic drug therapy, Iodine administration & dosage, Thyroxine administration & dosage
- Abstract
Aim: In patients with euthyroid goitre, the efficacy of treatment with 400 micrograms iodine and 100 micrograms levothyroxine combined with 100 micrograms iodine was compared to that of the previous standard of therapy, individually dosed levothyroxine., Patients and Methods: A total of 78 patients presenting with euthyroid diffuse goitre (> or = 25 ml) were prospectively enrolled, randomised and treated for 6 months. The course of thyroid volume was followed using thyroid volumetry., Results: Data of 69 patients were included in the final evaluation (57 women, 12 men, age 31 +/- 1 years, thyroid volume 31.5 +/- 1.4 ml, 23 per treatment group). In the patients treated with individually dosed levothyroxine, the thyroid volume decreased by about 39% (95%-confidence limit [CL]-31% to -41%). However, the volume reductions achieved in the patients treated with 400 micrograms iodine or 100 micrograms levothyroxine/100 micrograms iodine were not significantly different (p = 0.35, variance analysis, mono-iodine -34%, 95%-CL -29% to -43%, 100 micrograms levothyroxine/100 micrograms iodine -39%, 95%-CL -32% to -45%)., Conclusions: In patients with euthyroid diffuse goitre, treatment with mono-iodine or combination of levothyroxine with iodine should have principally the same status as the previous standard of therapy, individually dosed levothyroxine. In the view of the authors, its preferential treatment with mono-iodine appears most reasonable.
- Published
- 1997
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34. Recommended normative values for thyroid volume in children aged 6-15 years. World Health Organization & International Council for Control of Iodine Deficiency Disorders.
- Subjects
- Adolescent, Algorithms, Child, Female, Goiter, Endemic diagnostic imaging, Humans, Iodine deficiency, Iodine urine, Male, Reference Values, Ultrasonography, Thyroid Gland anatomy & histology, Thyroid Gland diagnostic imaging
- Abstract
Inspection and palpation are the traditional methods used to determine thyroid volume in areas of moderate-to-severe iodine deficiency. However, in areas of mild endemicity, and generally whenever goitres are small, ultrasonography is a safe, noninvasive technique that provides a more precise and objective method for determining thyroid volume. Ultrasonography should be undertaken by well-trained operators, whose correct interpretation relies on the availability of standardized reference criteria from populations whose iodine status is known to be adequate. A recent survey conducted among schoolchildren aged 6-15 years in 12 European countries provides ultrasound data for determining thyroid volume from 7599 subjects, and urinary iodine levels from 5709 subjects. A subgroup of 3474 children born and living in areas where iodine intake is normal-as evidenced by median urinary iodine above 100 micrograms/l-furnishes data from which to derive thyroid volume reference values. This article presents the upper normal limit for thyroid volume, according to age, for the iodine-replete boys and girls in this subgroup, assessed using ultrasonography. In countries with a high prevalence of child growth retardation, thyroid volume is provisionally considered to be more directly a function of total body surface area. Recommended upper normal limits of thyroid volume, calculated according to body surface area, are also reported. These cut-off values are recommended for interpreting survey and surveillance ultrasonography data among school-age children.
- Published
- 1997
35. [Thyroid gland ultrasound and urinary iodine excretion in children and adolescents with type I diabetes mellitus].
- Author
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Steiss JO, Otten A, Graef V, and Klingmüller V
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Diabetes Mellitus, Type 1 urine, Female, Glycated Hemoglobin metabolism, Glycosuria diagnostic imaging, Glycosuria urine, Goiter, Endemic urine, Humans, Male, Prospective Studies, Reference Values, Ultrasonography, Diabetes Mellitus, Type 1 diagnostic imaging, Goiter, Endemic diagnostic imaging, Iodine urine, Thyroid Gland diagnostic imaging
- Abstract
Background: Date, studies on thyroid volume and urinary iodide excretion in patients with diabetes mellitus are not available. Sonographically determined parameters of the thyroid size are correlated to other anthropometrous data and the urinary iodide excretion is correlated to glucosuria, the HbA1c value and the diabetes duration., Method: In this prospective study we evaluated sonographically the thyroid volume in 107 patients with type I diabetes mellitus and 112 healthy children. The urinary iodide excretion was measured photometrically by using a modified ceric ion arsenious acid method for spontaneous urinary specimen and if available for the 24 h collected urin., Results: The thyroid volume depended on site and age. A positive correlation of the thyroid volume and age, body weight and height, could be demonstrated. Referring to reference data a goitre prevalence of 30% in juvenile patients with diabetes mellitus type I was detected. Interestingly, juvenile type I diabetics presented with an average urinary iodide excretion of 183.0 micrograms iodide/g creatinine. Even the urinary iodide excretion of 162.5 micrograms iodide confirmed this increased level. The urinary iodide excretion in 24 hours correlated with glucosuria and the HbA1c level. The healthy children presented with an average urinary iodide excretion of 42.6 micrograms iodide/g creatinine. The mean value was clearly below the WHO recommendation of 150-300 micrograms iodide/g creatinine. Only 2.8% of the healthy children examined exceeded the lower limit of this range., Conclusion: In addition to the existing distinct under supply of iodide we assume an increased urinary iodide excretion in context with the osmotic diuresis in juvenile diabetics. Contrary to current opinion, that these data are correlated to the daily intake of iodide, which was calculated from urinary excretion rate, this thesis could not be affirmed for juvenile diabetics. Therefore it seems reasonable to frequently control thyroid volume and thyroid function in children and adolescents with diabetes mellitus.
- Published
- 1996
- Full Text
- View/download PDF
36. [The prevention of the recurrence of endemic goiter. The efficacy of a once-a-week dose of 1.53 mg iodide].
- Author
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Peters H, Hackel D, and Schleusener H
- Subjects
- Adolescent, Adult, Delayed-Action Preparations, Dose-Response Relationship, Drug, Drug Evaluation, Goiter, Endemic blood, Goiter, Endemic diagnostic imaging, Goiter, Endemic drug therapy, Humans, Middle Aged, Prospective Studies, Recurrence, Statistics, Nonparametric, Thyroid Gland diagnostic imaging, Thyroid Hormones blood, Time Factors, Ultrasonography, Goiter, Endemic prevention & control, Iodides administration & dosage
- Abstract
Objective: To investigate the efficacy of 1.53 mg iodide administered once weekly in the prophylaxis of goitre recurrence in patients with endemic euthyroid goitre after initial treatment to reduce the goitre size., Patients and Methods: 46 consecutive patients who had undergone initial L-thyroxine, iodide or combined treatment were included in the prospective study. Thyroid volume was measured sonographically at the beginning as well as 6 and 18 months later. An increase in thyroid volume of more than 15% was taken as recurrence., Results: The study was concluded in 41 patients. During the prophylaxis mean thyroid volume increased from initially 21.7 +/- 9.9 ml to 22 +/- 10.9 ml after 6 months and to 24.5 +/- 12.1 ml after 18 months (P < 0.01). While thyroid volume remained unchanged in at least two thirds of patients, a recurrence occurred in 32% (n = 13; from initially 22.7 +/- 9.7 ml, to 26.3 +/- 11.3 ml at 6 months and to 29.7 +/- 12.3 ml at 18 months). In all patients with a recurrence a doubling of the iodide dosage to twice weekly 1.53 mg for 6 months reduced thyroid volume again (mean of 25.7 +/- 10.0 ml; P < 0.01)., Conclusions: In at least two third of patients a once-weekly dose of 1.53 mg iodide is a reliable means of preventing a recurrence of endemic euthyroid goitre, but in the remainder the same dose must be increased to twice weekly.
- Published
- 1996
- Full Text
- View/download PDF
37. Somatostatin receptor expression in the thyroid demonstrated with 111In-octreotide scintigraphy.
- Author
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Becker W, Schrell U, Buchfelder M, Hensen J, Wendler J, Gramatzki M, and Wolf F
- Subjects
- Adult, Gene Expression, Goiter, Endemic diagnostic imaging, Goiter, Endemic metabolism, Humans, Male, Octreotide metabolism, Radionuclide Imaging, Receptors, Somatostatin analysis, Thyroid Diseases metabolism, Thyroid Gland metabolism, Thyroid Neoplasms metabolism, Thyrotropin blood, Thyroxine blood, Triiodothyronine blood, Ultrasonography, Indium Radioisotopes, Octreotide analogs & derivatives, Receptors, Somatostatin biosynthesis, Thyroid Diseases diagnostic imaging, Thyroid Gland diagnostic imaging, Thyroid Neoplasms diagnostic imaging
- Abstract
Neuroendocrine tumors with somatostatin receptor expression may be localized by 111In-octreotide scintigraphy. This study examines those thyroid conditions where 111In-octreotide uptake could be observed also in the thyroid gland. 26 consecutive patients who underwent 111In-octreotide scintigraphy for tumor localization were additionally examined for thyroid disease by sonography and 99mTc-pertechnetate scintigraphy. 12 of these patients had no significant thyroid uptake and had an euthyroid normal-sized thyroid gland 14 patients with 111In thyroid uptakes had endemic goiters, two of them with thyroid autonomy and one with Graves' disease. Thus, 111In-octreotide thyroid uptake was predominantly seen in patients with endemic goiter with or without thyroid autonomy.
- Published
- 1995
38. [Prevalence of goiter in the Aachen area. Ultrasound volumetry of the thyroid gland of 1,336 adults in an endemic goiter region].
- Author
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Riehl J, Kierdorf H, Schmitt H, Suiter T, and Sieberth HG
- Subjects
- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Germany epidemiology, Goiter, Endemic epidemiology, Humans, Incidence, Male, Middle Aged, Risk Factors, Goiter, Endemic diagnostic imaging, Mass Screening, Ultrasonography
- Abstract
Aim: The aim of the study was to assess the prevalence of thyroid enlargement by ultrasonic volume measurements., Results: 1336 adults living in the iodine-deficient area of Aachen, West Germany (760 females, 576 males, mean age: 54.05 +/- 16.09 years) were included in the investigation. The ultrasonic examination was carried out in patients who did not suffer from thyroid disease at the time of study., Results: The thyroid volume was age-dependent and varied from 13.3 +/- 10.4 ml in patients < 21 years to 29.9 +/- 24.3 ml in patients > 70 years. The prevalence of thyroid enlargement ranged from 14.3% in young people to 51.3% in the elderly. There was no difference in the volumes of the left and right thyroid lobe. The prevalence of thyroid enlargement was higher in females compared to males (p < 0.05). Retrosternal thyroid mass was detected in 25% of all patients > 70 years., Conclusion: There is evidence of a high prevalence of thyroid enlargement in iodine-deficient areas.
- Published
- 1995
- Full Text
- View/download PDF
39. [Endemic goiter in Moscow and Moscow region].
- Author
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Nazarov AN, Maĭorova NM, Sviridenko NIu, Kenzhibaeva MB, Arbuzova MI, Mishchenko BP, and Gerasimov GA
- Subjects
- Adolescent, Child, Goiter, Endemic diagnostic imaging, Goiter, Endemic urine, Humans, Iodine urine, Moscow epidemiology, Prevalence, Rural Health, Ultrasonography, Urban Health, Goiter, Endemic epidemiology, Iodine deficiency
- Abstract
Goiter prevalence and iodine excretion levels were assessed in schoolchildren aged 9 and 13 in the city of Moscow (n = 91) and the Moscow region, 60 km East of Moscow (n = 92). Goiter prevalence was evaluated by ultrasonography. In Moscow it was found to be 31.1% among children aged 9 and 17.5% among those aged 13. The respective values in the Moscow region were 47.2 and 39.3%. Medium urinary iodine levels were 6.9 to 7.5 micrograms/dl in Moscow and 4.1 to 5.4 micrograms/dl in the region. According to modern criteria, iodine deficiency in Moscow may be regarded as mild and in the region as moderate. Control programs are urgently needed tc prevent development of iodine deficiency disorders.
- Published
- 1994
40. [Echography of the thyroid gland in the diagnosis of endemic goiter].
- Author
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Bolotova NV, Lisenkova LA, Shchepliagina LA, Glukhova TV, Kruglov AV, and Perepelova EM
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Male, Mass Screening methods, Middle Aged, Russia, Ultrasonography, Goiter, Endemic diagnostic imaging, Thyroid Gland diagnostic imaging
- Abstract
Screening of 1520 children living in the Khvalynsk district of the Saratov region, including assessment of urinary excretion of iodine and ultrasonic examinations of the thyroid in children and adults, revealed endemic goiter in the region. Special attention was paid to echographic examination of the thyroid; this method was used in examinations of 161 children aged 2 to 14 with thyroid enlargement of the I-III degree. 103 (64.0%) of there children had enlarged thyroid, in some children with diffusely enlarged thyroid of the I-II degree ultrasonic examination showed no enlargement, and in some children the gland was found even reduced in size. The greatest discrepancy between the data of palpation and ultrasonography was observed in first-degree thyroid enlargement, the least so in second-degree enlargement; in third-degree enlargement there was no such a discrepancy. Assessment of thyroid structure revealed various disorders of the organ in 29 of the 161 examined children, these disorders present both in enlarged glands and in those of normal or reduced size. Nodes that could not be palpated were detected in 2 children. Ultrasonic examinations of 56 adults aged 20 to 60 revealed changed structure of the thyroid in 35, with nodes of various sizes and localization detected in 15 of these.
- Published
- 1994
41. [Scintigraphy of parathyroid adenomas with 99mTc-sestamibi in an endemic goiter area].
- Author
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Joseph K, Welcke U, Höffken H, Koppelberg T, and Rothmund M
- Subjects
- Adenoma surgery, False Negative Reactions, False Positive Reactions, Goiter, Endemic epidemiology, Humans, Injections, Intravenous, Parathyroid Neoplasms surgery, Prevalence, Adenoma diagnostic imaging, Goiter, Endemic diagnostic imaging, Hyperparathyroidism diagnostic imaging, Parathyroid Neoplasms diagnostic imaging, Technetium Tc 99m Sestamibi, Tomography, Emission-Computed methods
- Abstract
Recently 99mTc-Sestamibi (MIBI) has been introduced into parathyroid imaging. The purpose of this study was to evaluate the MIBI scan in an endemic goiter area. 25 patients with primary and 9 with secondary hyperparathyroidism (HPT) underwent a MIBI scan one day prior to surgical exploration of the neck. Cervicothoracic planar scintigraphy was performed 5, 15 and 120 min after i.v. injection of 444 MBq of 99mTc-Sestamibi. The MIBI scan correctly detected 20 of 25 adenomas in 25 patients with pHPT. In only 6 of 9 patients with parathyroid hyperplasia a focal uptake was found. The cause of one false-positive result in the control group was an increased MIBI uptake by a follicular adenoma of the thyroid. Parathyroid scintigraphy using 99mTc-Sestamibi as a single radiopharmaceutical is as sensitive in detecting and localizing parathyroid adenomas as the Tl/Tc-scintigraphy. Due to a high prevalence of thyroid adenomas in an endemic goiter area a higher rate of falsely positive results may be expected.
- Published
- 1994
42. Reevaluation of the results of iodine prophylaxis in eradication of endemic goiter in Macedonia.
- Author
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Karanfilski B, Sestakov G, Loparska S, Miceva-Ristevska S, Serafimov N, Tadzer I, Bogdanova V, Georgievska B, Simova N, and Vaskova O
- Subjects
- Adolescent, Child, Female, Goiter, Endemic diagnostic imaging, Goiter, Endemic epidemiology, Humans, Male, Republic of North Macedonia epidemiology, Ultrasonography, Goiter, Endemic prevention & control, Iodine therapeutic use
- Abstract
In order to reevaluate effectiveness of iodine prophylaxis in Macedonia, epidemiological, ultrasonographic studies and estimation of urine excretion were performed. The results from the epidemiological survey in nongoitrogenic regions demonstrated goiter between 12.8% and 18%. Much higher prevalence of goiter was found in goitrogenic regions, between 20.8% and 60.8%. The incidence of goiter increased with age, and its prevalence is higher in girls when compared with the boys of the same age group. The thyroid volume estimated by ultrasonography was higher in children from goitrogenic regions when compared to nongoitrogenic. There was a good correlation between ultrasonographic volumetry data and size of the thyroid estimated by palpation. Urinary iodine excretion demonstrated low values in children from goitrogenic regions as indicator of iodine deficiency.
- Published
- 1993
43. [Comparison of the data of palpation and ultrasonic examination in assessing the dimensions of the thyroid gland].
- Author
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Gerasimov GA and Gutekunst R
- Subjects
- Female, Goiter, Endemic diagnostic imaging, Goiter, Endemic epidemiology, Humans, Male, Russia epidemiology, Thyroid Gland diagnostic imaging, Ultrasonography, Goiter, Endemic pathology, Palpation, Thyroid Gland pathology
- Abstract
Comparison of the thyroid-sizes estimated by palpation and ultrasonic scanning in 282 women and 178 men has shown that if the thyroid is small (from 0 to 2nd degree, according to O. V. Nikolayev's classification), its size cannot be estimated by palpation and this method fails to assess the endemic goiter in epidemiologic surveys. Correlation between the thyroid size estimated by palpation and its ultrasonically assessed volume has made up 0.346 (p < 0.001) in women and 0.193 (p < 0.01) in men. Ultrasonic assessment of the thyroid volume appears useful both for clinical and epidemiologic studies.
- Published
- 1992
44. [Incidence and importance of thyroid gland changes in clinical patients].
- Author
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Grün R, Grziwotz R, Sodomann CP, and Kaffarnik H
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Germany epidemiology, Goiter, Endemic diagnostic imaging, Humans, Incidence, Male, Middle Aged, Ultrasonography, Goiter, Endemic epidemiology, Thyroid Function Tests
- Abstract
The thyroid gland of 536 patients of a medical hospital in an iodine deficient area was investigated by ultrasound. According to the sonographic pattern and to the scintigraphic imaging the focal lesions were analysed as micro- or macrofollicular adenomas, autonomous adenomas, cysts and chalk. The prevalence of goitres was 37.7%. The prevalence of goitres was higher in women (45%) than in men (30%). Focal lesions could be observed in 27.6%, equally more often in women (36%) than in men (18.9%). The frequency of focal lesions increased with the age of the patients and with the volume of the thyroid gland. Autonomous adenomas were found three times more often in women than in men. Hyperthyroidism was only observed in patients with nodules larger than 4 cm in diameter. Sonographic screening examinations of the thyroid gland seem to be useful in all patients of a clinic of medicine because of the risk (25%) of iodine contamination by diagnostic measures.
- Published
- 1992
45. Endocrine imaging in the management of goiter and thyroid nodules: Part I.
- Author
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Beierwaltes WH
- Subjects
- Humans, Iodine Radioisotopes, Radionuclide Imaging, Goiter, Endemic diagnostic imaging, Thyroid Neoplasms diagnostic imaging, Thyroiditis, Autoimmune diagnostic imaging
- Published
- 1991
46. [Autonomous thyroid nodule: relations between clinical symptomatology and goiter endemia].
- Author
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Giuliani C, Napolitano G, Francomano F, Bucci I, Napolitano L, Lio S, Napolitano AM, and Monaco F
- Subjects
- Adult, Female, Goiter, Endemic diagnosis, Goiter, Endemic diagnostic imaging, Humans, Iodine deficiency, Italy epidemiology, Male, Middle Aged, Thyroid Diseases diagnosis, Thyroid Diseases diagnostic imaging, Ultrasonography, Goiter, Endemic epidemiology, Thyroid Diseases complications
- Abstract
Sixty-three patients with autonomous thyroid nodule were studied, thirty-five from an endemic goiter area (EA) and twenty-eight from a non-endemic goiter area (NEA). Clinical history, physical examination, ultrasonography, thyroid hormone levels, and fine needle aspiration (FNA), were utilized to investigate whether or not iodine deficiency determined differences in the latency of progression to toxicity, the seriousness of illness and thyroid hormone levels. No significant difference was observed in the age of onset of nodularity, while the latency of progression to toxicity was significantly decreased in the EA (p less than 0.001). The ultrasonographic pattern did not show significant volume variations between the EA and NEA, but there was a slight prevalence of multinodular lesions in EA. No significant difference in serum thyroid hormone levels was found between the two areas in non toxic patients, while at the onset of hyperthyroidism higher levels of FT were observed in the EA than in the NEA. FNA showed a prevalence of colloid lesions in EA, while hyperplastic lesions prevail in the NEA. Forty-two patients underwent surgery: the extent of surgery was greater in patients from the EA. In conclusion, in iodine deficient areas earlier clinical thyrotoxicosis and a higher prevalence of hypoactive thyroid nodules were observed. Furthermore, in EA, the autonomous nodule in non toxic phase is more frequently associated with colloid lesions than hyperplastic lesions.
- Published
- 1991
47. [Global 99mTc uptake in the differential diagnosis of a normal thyroid,goiter with euthyroidism and thyroid autonomy in an area of iodine deficiency].
- Author
-
Kreisig T, Pickardt CR, Horn K, Bechtner G, Vaitl C, Kirsch CM, and Knesewitsch P
- Subjects
- Adult, Aged, Diagnosis, Differential, Female, Goiter metabolism, Goiter, Endemic metabolism, Humans, Male, Middle Aged, Radionuclide Imaging, Reference Values, Thyroid Gland metabolism, Goiter diagnostic imaging, Goiter, Endemic diagnostic imaging, Sodium Pertechnetate Tc 99m pharmacokinetics, Thyroid Gland diagnostic imaging
- Abstract
Global TcTU was determined in 568 patients without any specific thyroid drug intake--54 with normal thyroid, 274 with goitre and euthyroidism and 240 with thyroid autonomy. 57 patients with autonomy and overt hyperthyroidism were the only group with TcTU values significantly higher than normals. Common to all groups was a large scatter of the TcTU values. In 332, the effects of individual iodine supply were studied by measuring the iodine concentration in spot urine samples. There was a significant inverse correlation between the TcTU values and the urinary iodine excretion in the groups of normal thyroids and of goitres with euthyroidism. In the group with autonomy an effect of iodine supply could only be seen in cases of greatly increased urinary iodine excretion, resulting in very low TcTU values. Out of 20 patients with autonomy and iodine contamination, only 4 showed overt hyperthyroidism. The large scatter of TcTU values in all groups may be explained by the persistent iodine deficiency as well as by the frequent exposure to unknown amounts of iodine in patients with thyroid disease. Therefore, the spontaneous TcTU alone cannot identify a small group of patients with autonomy and high risk of iodine-induced hyperthyroidism, from a very large group of patients with goitre.
- Published
- 1990
48. [Early and late results of 131I treatment of benign goitres in an endemic area in southern bavaria (author's transl)].
- Author
-
Frey KW
- Subjects
- Disease Reservoirs, Germany, West, Goiter, Endemic diagnostic imaging, Humans, Hypothyroidism chemically induced, Iodine adverse effects, Middle Aged, Radionuclide Imaging, Retrospective Studies, Goiter, Endemic drug therapy, Iodine therapeutic use
- Abstract
Following the application of 10 000 to 15 000 rd, to 471 patients with benign goitres, mechanical symptoms were relieved in 72 to 82% during a course of six follow-up examinations; the circumference of the neck was reduced by 1.2 to 1.6 cm., the scintigraphic area by 9 to 31% and maximal 131I uptake was reduced by 18 to 31%. Follow-up examinations at 6.4 and 5.5 years in 155 patients showed the best regression of neck circumference (2.2 to 2.6 cm.) and of the area of the scintigram (28 to 31%). 50% of the patients had had recurrences from previous goitre removals and 1 to 3% developed post-therapeutic hypothyroidism. There was no significant change in the level of the peripheral thyroid hormones following treatment, but 10 to 20% were within the hypothyroid range for the area of iodine deficiency.
- Published
- 1979
- Full Text
- View/download PDF
49. Thyroid autonomy: sensitive detection in vivo and estimation of its functional relevance using quantified high-resolution scintigraphy.
- Author
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Bähre M, Hilgers R, Lindemann C, and Emrich D
- Subjects
- Adolescent, Adult, Aged, Female, Goiter, Endemic metabolism, Humans, Male, Middle Aged, Organ Size, Radionuclide Imaging, Sodium Pertechnetate Tc 99m, Thyroid Gland metabolism, Thyrotropin metabolism, Thyrotropin-Releasing Hormone pharmacology, Thyroxine metabolism, Triiodothyronine metabolism, Goiter, Endemic diagnostic imaging, Thyroid Gland diagnostic imaging
- Abstract
This study is concerned with 236 euthyroid individuals living in an area of iodine deficiency, 227 of whom had endemic goitres. In these subjects, autonomy could be suspected owing to an inhomogeneous activity distribution on the thyroid scintigram or a subnormal TSH response to TRH. They complete a total number of 426 investigated individuals. Previously, in 190 separated controls without evidence of autonomy, the reference ranges for the thyroid 99mTc pertechnetate uptake under suppression (TcUs), a measure for the non-suppressible thyroid iodide clearance, and for suppressibility of circumscribed thyroid regions, had been determined. These two parameters obtained by high-resolution quantified scintigraphy were used for an accurate detection of thyroid autonomy among the 236 individuals. Suppression scintigraphy revealed autonomy in 171 patients. delta TSH after TRH was subnormal in 40% of the subjects with abnormal thyroid suppressibility. Prevalence of abnormal suppression was dependent on three factors: patient age, goitre type and estimated thyroid weight. In the total investigated collective, the prevalence of autonomy was 77% in patients with a goitre weight above 50 g. The individuals with abnormal suppression were grouped into four classes of TcUs. In these classes, free thyroxine index (FT4I) and total triiodothyronine (TT3) increased with increasing TcUs, whereas delta TSH decreased. This finding indicates a continuum of different extents of autonomous thyroid function, whereas in the individual patient, the extent can be determined using the pertechnetate uptake under suppression. In addition, FT4I, TT3 and delta TSH in each of the TcUs classes depended on the individual iodine supply.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1988
- Full Text
- View/download PDF
50. [Possibilities of the radioisotope study of thyroid gland function in "blockade" by iodine and bromine preparations (based on data from the Buryat ASSR)].
- Author
-
Spasov SA
- Subjects
- Goiter, Endemic diagnostic imaging, Goiter, Endemic drug therapy, Humans, Iodine Radioisotopes, Radionuclide Imaging, Siberia, Thyroid Gland drug effects, Time Factors, Bromine therapeutic use, Iodine therapeutic use, Thyroid Function Tests methods, Thyroid Gland diagnostic imaging
- Published
- 1978
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