Evaluation of serum vitamin A and urinary iodine levels among goitrous adolescents in Mousl, Iraq

To assess the frequency of endemic goiter in secondary school students in Mosul in northern Iraq and to compare serum vitamin A and urinary iodine excretion between goitrous and non-poitrous students. This study was conducted in Mosul, Iraq from November 2002 through April 2004. A sample of 473 students [aged 13-20 years] from different schools of this area was selected and classified according to socioeconomic status. A pre-tested questionnaire was employed to obtain information on gender, birth date, height, weight, residence, habitual food consumption patterns, and socioeconomic status. Physical examination of the thyroid gland was then done including size, constistency, and grade. Casual morning urine and blood samples were collected from 200 students of the 463 students, 70 males and 130 females. Laboratory measurements for thyroid stimulating hormone [TSH], total thyroxin [T4], vitamin A serum protein, serum albumin, and urinary iodine and creatinine were performed. The students were initially divided into three groups according to grade of goiter. The frequency rate of goiter according to WHO criteria was 28.8% in females and 23.6% in males, with a higher frequency among females aged 17-20 years. Serum vitamin A levels in non-goitrous students [control group] were higher in females than in males and this difference persisted in different age groups. Urinary iodine excretion in the two age groups was higher in males than in females. Among goitrous students, urinary iodine excretion and serum vitamin [opposite of that observed in the control group] were higher in males than in females in the age group of 17-20 years. All the goitrous students had serum vitamin A<0.35 micro mol/L which is deficient according to WHO [1996] criteria. A highly significant correlation was observed in goitrous students between serum vitamin A and urinary iodine excretion [r=0.45, P<0.0001]. Goiter is still an endemic problem for secondary school students in Mosul in northern Iraq. Vitamin A and iodine deficiencies are common health problems in this area. It may be useful to measure serum iron and zinc in goitrous students and to clarify whether or not there is a correlation between these two parameters and serum vitamin A and urinary iodine

Conducta espectativa ante el bocio eutiroideo puberal / Spectative conduct before the puberal euthyroid goiter

Se siguió espectativamente a 25 niños con bocio eutiroideo en época puberal (23 hembras y 5 varones), mediante la realización de un estudio clínico bioquímico (TSH) semestral durante 1 año, con el objetivo de valorar la eficacia de esta conducta. No se encontraron afectaciones de la talla y la progresión de los estadios puberales de Tanner en estos pacientes sin tratamiento medicamentoso. No existió variación en tamaño del bocio, ni en el valor de la TSH que siempre fue bajo (<20 Mu/L) en los pacientes que no hicieron hipotiroidismo. En el seguimiento se detecto hipotiroidismo subclínico en 3 pacientes, lo cual sugiere que esta conducta sea útil, por cuanto permite captar el hipotiroidismo subclínico cuando la TSH sea mayor e igual 10 Mu/L y así comenzar tratamiento en estos pacientes, evitando un tratamiento innecesario y prolongado con hormonas tiroideas a todo paciente con bocio eutiroideo

Bocios simples: classificaçäo, diagnóstico e tratamento / Non-toxic goiter: classification, diagnosis and treatment

A conceituacao e a classificacao dos bocios sao apresentadas. Os aspectos clinicos e laboratoriais envolvidos no tratamento dos bocios simples sao discutidos. As indicacoes de tireoidectomia em casos de bocios simples sao: suspeita de neoplasia maligna, presenca de fenomenos compressivos, insinuacao para o torax e desconforto estetico

Bocios toxicos: classificaçäo, diagnóstico e tratamento / Toxic goiter: classification, diagnosis and treatment

Os bocios toxicos, caracterizados pela presenca de hipertireoidismo, podem ser classificados em difusos ou nodulares, definindo-se entidades clinico-patologicas bem estabelecidas. O diagnostico, o tratamento e o acompanhamento de pacientes portadores de bocio toxico e discutido

Iodine deficiency disorders in school children of Sikkim.

Sikkim is a small state in the eastern Himalayas. A survey was conducted to determine the prevalence of iodine deficiency disorders in the state. A two stage sampling procedure was adopted. In stage one, all villages in the state were listed and 249 were randomly selected for the survey. In stage two, households, were randomly selected from the selected villages using the electoral lists. The basic sampling unit was a household and all members of the households were studied. A total of 17,837 subjects were studied from 3,197 households of 249 villages. Overall prevalence of goitre and cretinism in the community as a whole, were 54.03% and 3.46% respectively. Of the population studied, 5939 were children in the age group of 5 to 16 years. There were 3,005 boys and 2,934 girls. Goitre was detected in 3,381 (56.9%). Goitre prevalence in the boys was 55.4% and in girls it was 58.5% (p = < 0.05). Grade I goitre was seen in 2,472 (73.1%), grade II in 888 (26.3%) and grade III in 21 (0.6%). Endemic cretinism was diagnosed in 175 subjects (2.9%). Cretinism prevalence in the boys was 3.1%, and in girls in was 2.8% and this difference was not significant. Neurological; cretinism was the predominant form (98.3%). Estimation of urinary iodine concentration in 167 subjects revealed the mean concentration to be 3.64 u/dl (SD 2.47). The median value was ug/dl indicating the skewed distribution of the urinary iodine concentration. The study shows the existence of severe iodine deficiency in the school-aged children of Sikkim.(ABSTRACT TRUNCATED AT 250 WORDS)

Cáncer del tiroides / Thyroid cancer

Se presentan 92 casos de cánceres tiroideos operados entre 1972 y 1992. Se analizan las características clínicas de la serie, los procedimientos quirúrgicos efectuados y los resultados alejados. En el 69,5 por ciento de los casos el bocio fue uninodular. El 55,5 por ciento de los bocios malignos estudiados mediante cintigrafía fueron hipocaptantes. La punción citológica fue de gran rendimiento en 18 casos sometidos a ese estudio diagnóstico. Trece pacientes fallecieron por cáncer del tiroides. Quince se perdieron de control. El resto de la serie se controló entre 3 meses y 26 años después de la operación. Veinticuatro pacientes se controlaron más de cinco años. La mortalidad operatoria fue de 2,17 por ciento. El tratamiento radiante con I 131 o radioterapia externa no tuvo eficacia para modificar el curso de metástasis establecidas

Les goitres simples: etude de 117 cas a Brazzaville

Une analyse retrospective de 117 cas de goitres simples ou euthyroidiens a permis l'etude au plan epidemiologique des aspects fondamentaux de cette pathologie au Congo. Il apparait que les goitres representent 58;12 pour cent de l'ensemble de la pathologie thyroidienne et 25;6 pour cent de toute l'activite du service. L'auteur donne la frequence; le sex-ratio; les differentes formes de goitres ainsi que leur classification d'apres Guinet

Surgery for thyroid goiter in western India. A prospective analysis of 334 cases.

334 consecutive cases of thyroid swellings operated by a single surgical unit over 9 years have been analysed prospectively. There was a female preponderence (4.39:1). The swellings were clinically differentiated into uninodular (39.52%), multinodular (47.31%) and diffuse (13.17%). Hyperthyroidism was manifested in 49 cases (14.67%). Pressure symptoms were present in only 1.5% cases. FNAC detected malignancy in 14 of 162 cases (8.64%). The initial 100 cases were operated upon by standard Lahey's technique and the latter 234 by modified technique described by Bapat et al for benign thyroid disease. Operations performed included nodulectomies (5.39%), hemithyroidectomies (41.92%), partial thyroidectomies (25.75%), subtotal (25.45%) and near total thyroidectomies (1.5%). Post-operative complications were higher in the first group and included unilateral cord palsies-5 (5%). hypocalcemia-4 (4%) hypoparathyroidism-1 (1%) haemorrhage-1 (1%) and mortality-1 (1%) vis a vis cord palsies-2 (0.85%), hypocalcemia-3 (1.28%), hypoparathyroidism-1 (0.43%) and there was no mortality. Histopathology revealed 83 (24.85%) colloid goiters, 193 (57.78%) nodular goiters, 21 (6.29%) follicular adenomas, 7 (2.10%) cases of thyroiditis and 30 (8.98%) malignancies. This study reveals the lower incidence of RLN palsy after modified thyroidectomies, and a low incidence of malignancy.