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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

In this work, based on the research of treatment results of 646 patients that were operated for nodular and multinodular nontoxic goiter in Hospital St. Elizabeth endocrinology center, in the period from 1997 to 2013, an analysis of the malignant tumor frequency in patients with follicular thyroid tumors who underwent surgical treatment for the nodular goiter was performed. In this group gender and age characteristics of patients with follicular thyroid tumors were identified, and also an evaluation of surgical treatment safety in patients operated for follicular thyroid tumors was performed.

With using a Raven test, technique of memorization of 10 words and Toulouse-Pieron test was studied cognitive state of adolescents with diffuse nontoxic goitre (DNG), taking into account the state of the thyroid system. It was shown that in the light iodine deficiency 44.7 % of adolescents with DNG have negative changes in the intellectual-mental sphere, mainly due to the disorders of attention, reduce the amount of short-term and long-term memory. Nearly in third of the surveyed adolescents with DNG diagnosed psychological signs of minimal brain dysfunction and decreased the operability. There is a strong relationship between the cognitive function and functional state of the thyroid system. Most negatively thyroid dysfunction affects on the amount of long-term memory and concentration of attention. The authors note the need of diagnostic and therapeutic algorithm for examination of children and adolescents with DNG, which would include not only the evaluation of the morphofunctional state of the thyroid gland, but also and evaluation of intellectual-mental sphere, the timely usage of a complex system of medical and psychological rehabilitation, aimed on supporting of cognitive function in patients with this pathology

BACKGROUND AND PURPOSE: Patient-reported outcomes have become important endpoints in comparative effectiveness research and in patient-centered health care. Valid patient-reported outcome measures detect and respond to clinically relevant changes. The purpose of this study was to evaluate responsiveness of the thyroid-related quality of life (QoL) instrument ThyPRO in patients undergoing relevant clinical treatments for benign thyroid diseases and to compare it with responsiveness of the generic SF-36 Health Survey.METHODS: A sample of 435 patients undergoing treatment completed the ThyPRO and SF-36 Health Survey (Version 2) at baseline and 6 months after treatment initiation. Responsiveness was evaluated in three thyroid patient groups: patients with hyperthyroidism (n = 66) and hypothyroidism (n = 84) rendered euthyroid after medical therapy, and patients with a clinically detectable nontoxic goiter treated with surgery or radioactive iodine and remaining euthyroid (n = 62). Changes in QoL were evaluated in terms of effect size and compared to the changes predicted by clinical experts. The responsiveness of equivalent scales from ThyPRO and SF-36 Health Survey were compared with the relative validity index.RESULTS: The ThyPRO demonstrated good responsiveness across the whole range of QoL aspects in patients with hyper- and hypothyroidism. Responsiveness to treatment of nontoxic goiter was also demonstrated for physical and mental symptoms and overall QoL, but not for impact on social life or cosmetic complaints, in contrast to clinicians' predictions. For all comparable scales except one, the ThyPRO was more responsive to treatment than the SF-36 Health Survey.CONCLUSIONS: The ThyPRO was responsive to treatment across the range of benign thyroid diseases. We suggest implementing this measurement instrument as a patient-reported outcome in clinical studies and in clinical management.

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

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

Neoplasms of the lacrimal drainage system are uncommon, but potentially life-threatening and are often difficult to diagnose. Among primary lacrimal sac tumors, benign mixed tumors are extremely rare. Histologically, benign mixed tumors have been classified as a type of benign epithelial tumor. Here we report a case of benign mixed tumor of the lacrimal sac.

A relatively simple and inexpensive technique to train surgeons in phacoemulsification using a goat's eye integrated with a human cataractous nucleus is described. The goat's eye is placed on a bed of cotton within the lumen of a cylindrical container. This is then mounted on a rectangular thermocol so that the limbus is presented at the surgical field. After making a clear corneal entry with a keratome, the trainer makes a 5-5.5 mm continuous curvilinear capsulorhexis in the anterior lens capsule, creates a crater of adequate depth in the cortex and inserts the human nucleus within this crater in the goat's capsular bag. The surgical wound is sutured, and the goat's eye is ready for training. Creating the capsulorhexis with precision and making the crater of adequate depth to snugly accommodate the human nucleus are the most important steps to prevent excessive wobbling of the nucleus while training.

We report a case of the primary deep orbital venous varix treated by endovascular coil embolization procedure by transfemoral catheterization. This method of treatment has the advantage of image-guided localization of the pathology, real-time management and confirmation of the success of the procedure in the sitting.