Thyroid nodules in childhood: a single institute experience

Thyroid nodules are rare in children. Multiple diagnostic modalities are used to evaluate the thyroid mass. The aim of this study was to determine results of management of thyroid nodules in children with special attention to the role of fine needle aspiration biopsy, [FNAB] in diagnosis. Thirty-two children who underwent surgery for thyroid nodules in Mofid Children's Hospital within 10 years [1996 to 2005] were retrospectively studied. From clinical records we [obtained data about demographic characteristics, clinical manifestations, ultrasonography [USG] findings, and FNAB results, pathological reports, surgical therapy and complications. Data was analyzed statistically for association with thyroid cancer. Twenty-five patients [78.1%] were girls, and 7 [21.9%] boys. Mean age was 10.9 [range 8 to 14] years. 24 [75%] patients had benign and 8 [25%] malignant tumors. 18 [56.25%] nodules were located in the right lobe. Statistical analysis revealed sensitivity, specificity, accuracy, and positive and negative predictive values as follows: 80%, 65%, 25%, and 86% for USG; 35%, 41%, 40%, 18%, and 66% for RNS; 91%, 94%, 90%, 74%, and 96% for FNAB respectively. Clinical judgment as determined by serial physical findings with USG continues to be the most important factor in the management of thyroid nodules in children. FNAB is the most accurate method of investigation and its accuracy is improved by USG guidance

Acute inflammatory demyelinating polyneuropathy in children; clinical and electrophysiologic findings

The aim of this study was to evaluate the electrophysiologic findings of Guillain Barre Syndrome [GBS] in children and their relation with clinical progress of the disease. Twenty-three children with GBS were evaluated between 2005 and 2007. Electrophysiologic evaluations were performed at admission and one month later. Five patients needed respirator, 15 were bedridden, 1 developed recurrence 6 months later, and 2 experienced chronic GBS. The most common findings included: decreased amplitude of muscle action potential [CMAP] [96%], increased distal latency [74%], increased F wave latency [69%], and decreased nerve conduction velocity [NCV] [61%]. Sensory nerve conduction [evaluating sural nerve] was normal in 78% of the cases. These measures did not significantly change after 1 month. Electrodiagnostic evaluations are helpful at the primary stages of GBS for diagnosis. Fibrillation potentials and positive sharp waves showing denervation and axonal injury are presentative of longer duration of the disease and a worse prognosis

Urogenital tract abnormalities associated with congenital anorectal malformations

Genitourinary anomalies in patients with imperforate anus are a frequent source of significant morbidity. Variability of reports on the incidence of associated anomalies with imperforate anus mandates investigation on this issue. The case records and imaging studies of 105 patients who underwent surgery for imperforate anus over a 10-year period are retrospectively reviewed. Voiding cystouretherography, intra venous pyelography [IVP] and ultrasound were performed in patients with intermediate or high level anorectal lesions. During 10 years, there were 48 boys [45.7%] and 57 girls [54.3%] with imperforate anus. Genitourinary anomalies were seen in 34 [48.6%] patients with intermediate or high level anorectal lesions. Eighteen of them [52.9%] were shown to have vesicouretral reflux, only 6 of them required surgical correction. Vesicoureteral reflux was the most prominent urologic anomaly; other anomalies such as ureteropelvic junction [UPJ] stenosis, hydronephrosis, hypospadias, renal agenesis and undescended testis were seen in these series Patients with anorectal malformations should be evaluated for urinary tract and spinal anomalies