Substernal goiter and laryngopharyngeal reflux

ABSTRACT Objective This study aims to compare the prevalence of laryngopharyngeal reflux signs between two groups of patients undergoing thyroidectomy for voluminous goiter: substernal goiters and voluminous cervical goiter without thoracic extension. Subjects and methods A retrospective case-control study was performed with data retrieved of the charts of the patients submitted to thyroidectomies occurred at a tertiary care center (Head and Neck Surgery Department, University of São Paulo Medical School) between 2010 and 2014. The selected thyroidectomies were allocated in two groups for study: patients with substernal goiters and patients with voluminous cervical goiter without thoracic extension. Cervical goiters were selected by ultrasonography mensuration. Clinical criterion was used to define substernal goiter. Results The average thyroid volume in patients with substernal goiter was significantly greater than the average volume in patients with only cervical goiter (p < 0.001). The prevalence of signs of reflux laryngitis at laryngoscopy was significantly greater in substernal goiter patients (p = 0.036). Moreover, substernal goiter was considered as the unique independent variable for high reflux laryngitis signs at laryngoscopy (OR = 2.75; CI95%: 1.05-7.20; p = 0.039) when compared to only cervical goiter patients. Conclusion This study shows a significant association between substernal goiters and signs of laryngopharyngeal reflux at preoperative laryngoscopy. Therefore, when compared with voluminous cervical goiters, the substernal goiters increase the chance of reflux laryngitis signs in patients.

Trastornos tiroideos en pacientes con falla ovárica prematura / Thyroid disorders in patients with premature ovarian failure

La falla ovárica prematura (FOP), también llamada menopausia precoz, se define como la pérdida de la función cíclica de los ovarios antes de los 40 años de edad y después de la pubertad. Se ha reportado anormalidades endocrinas y autoinmunes asociadas con la FOP y se ha sugerido que las enfermedades tiroideas son comunes. Sesenta y dos mujeres con FOP fueron estudiadas para determinar la frecuencia de trastornos tiroideos, ya que no hay estudios sobre esta asociación en esta región geográfica. La evaluación incluyó historia clínica y examen físico, medición de tiroestimulina (TSH)...

Thyroid stimulating hormone [TSH] levels in euthyroid patients with goiter, a clinicopathological study

300 subjects, 39 males and 261 females, between the ages of 6 years and 70 years, were studied at Pakistan Institute of Medical Sciences [PIMS] and Nuclear Medicine, Oncology and Radiotherapy Institute [NORI] to assess the role of Thyroid Stimulating Hormone [TSH] in the development of goiter in euthyroid goitrous population of Islamabad and Rawalpindi area. The euthyroid goitrous subjects were selected by clinical Examination. Radioisotope uptake scan was done to confirm the clinical assessment of the status of the thyroid gland. The estimation of the serum levels of the thyroid hormones and TSH was done by Radioimmunoassay [RIA] and the estimation of serum levels of immunoglobulins A, G and M by Radial Immunodiffusion [RID]. TSH was found to be elevated in 9% of the study subjects while immunoglobulins were elevated in 66.67% of the subjects. The results of the study reveal the goitrogenic role of TSH in a small portion, while immunological phenomenon appears to be active in a significant portion of the euthyroid goitrous population of Islamabad and Rawalpindi area

Apoptose em tiroidopatias hiperplásicas e neoplásicas / Apoptosis in hyperplasic and neoplasic thyroid diseases

A apoptose é um processo de morte celular que ocorre geralmente após a fragmentação progressiva do DNA e parece ser importante em tecidos normais e neoplásicos. Pouco é conhecido sobre a ocorrência da apoptose nas doenças da tiróide. A finalidade deste estudo é investigar um possível papel da apoptose no crescimento do carcinoma bem diferenciado de tiróide, usando um ensaio com nucleotidil transferase in situ (ENTIS), o qual detecta a fragmentação do DNA, para determinar a fre-qüência da apoptose no bócio colóide (BC), adenoma folicular (AF), carcinoma folicular (CF) e carcinoma papilar (CP). Os tecidos de BC (n=3), AF (n=2), CF (n=4) e CP (n=3) foram obtidos de ressecção cirúrgica em 12 pacientes. As células apoptóticas positivas (CAP) dentro do folículo tiroidiano e tecido neoplásico foram contadas em áreas de 1cm 2 . O teste T foi utilizado para testar a significância estatística. O número de CAPs foi significantemente maior (p<0,0001) nos BC e AF (24,4 +/- 8,2 CAP/cm 2 ) comparado com CF e CP (1,33 +/- 0,82 CAP/cm 2 ). Nenhuma diferença significativa foi vista no número de CAPs entre BC e AF e entre CF e CP. A apoptose pode desempenhar um importante papel na progressão do carcinoma bem diferenciado de tiróide, visto que no presente estudo o índice apoptótico foi muito baixo nessas neoplasias. A apoptose, diferentemente da necrose, é um processo ativo que poderia ser inibido ou induzido o que, neste caso, seria interessante para a terapêutica.

Cassava, protein and iodine interaction in the thyroid status of rats

The possible synergistic role of dietary cyanide from cassava, low iodine intake and protein deficiency and/or imbalance on the thyroid status and goiter endemia in Akungba and Oke-Agbe villages in Akoko area of south-western Nigeria was investigated using rats as model. Thirty [30] weaning albino rats were fed on corn starch or cassava as the major source of carbohydrates, 3.5 and 10.0% levels of protein supplied by either casein or Amaranthus viridis and a salt mixture with or without iodine for 42 days. Cassava with a total hydrocyanic acid [HCN] content of 25 mg kg-1 DW did not cause growth depression when fed to rats with casein at 10% protein level, Iodine deficiency resulted in slightly higher weight gain while protein deficiency especially the vegetable rations caused significant growth reductions. Interaction between cassava/iodine deficiency and protein imbalance, especially in the vegetable rations, caused a significant increase in the weight of the thyroid gland when expressed as% of body weight. Dietary cyanide caused a significant increase in serum and urinary thiocyanate levels while iodine deficiency caused a significant reduction in the plasma protein-bound iodine [PBI]. These results would partially explain the goiter endemia in Akungba and Oke-Agbe villages whose nutritional status was mimicked in these experiments

Bocio no endémico en niños y adolescentes / Non endemic goiter in children and teenagers

Se presentan las causas de bocio no endémico en 116 niños y adolescentes; el 89 por ciento presentó bocio difuso, siendo la Tiroiditis Linfocítica crónica (Tiroiditis de Hashimoto) la principal causa de bocio difuso normofuncionante e hipofuncionante, y la enfermedad de Graves-Basedow, la de bocio difuso hiperfuncionante. El bocio nodular representó el 10.3 por ciento de los casos de bocio no endémico, de estos, el 83.3 por ciento correspondió a patología benigna, y el 16.7 por ciento a patología maligna.