Thyroid autoimmunity in children and adolescents with newly diagnosed type 1 diabetes mellitus.

PURPOSE: This study aim to investigate the occurrence of autoimmune thyroid disease in children and adolescents at onset of type 1 diabetes mellitus (T1DM) and to assess whether the presence of diabetes-specific autoantibodies can predict the autoimmune thyroid disorder. METHODS: Seventy-three children with T1DM were recruited. Glutamic acid decarboxylase antibodies (GADA), islet cell antibodies (ICA), insulin autoantibodies (IAA), and thyroid antibodies were determined in all patients at the time of diagnosis. RESULTS: The majority of patients (87.7%) had at least one pancreatic antibody (74.0% for GADA, 20.5% for ICA, and 24.7% for IAA). Thyroid autoantibodies were found in 19 of 73 patients (26.0%) at diagnosis. Thyroid autoimmunity (TA) incidence was not statistically significant by GADA or ICA positivity, but significantly higher by IAA positivity (P=0.03), and IAA positivity showed odds ratio, 4.931; 95% confidence interval, 1.323-18.381 for TA. CONCLUSION: The IAA positivity in children and adolescents with TIDM was strongly related to positivity of thyroid autoantibodies and thus it could serve as an index for early prediction of the development of the thyroid autoimmune disorder among children and adolescents with TIDM.

Random urinary calcium/creatinine ratio for screening hypercalciuria in children with hematuria.

BACKGROUND: Hypercalciuria is one of the most common causes of unexplained isolated hematuria. The diagnostic methods for hypercalciuria have not yet been standardized. The aim of this study was to assess whether random urinary calcium/creatinine ratio could be used as a screening tool for hypercalciuria in children with hematuria. METHODS: This prospective study included 264 children with primary hematuria for whom both random and 24 hr urinary evaluations were performed. Pearson correlation and ROC curve were used to assess the correlations. A multiple linear regression model was used to analyze effects of age, weight, height, body mass index, and body surface area on random urinary calcium/creatinine ratio. RESULTS: There was a moderately strong correlation between random urinary calcium/creatinine ratio and 24 hr urinary calcium excretion (r=0.584, P<0.001). The most appropriate cutoff value of random urinary calcium/creatinine ratio for the estimation of hypercalciuria was 0.075 mg/mg (sensitivity, 77.8%; specificity, 64.3%; area under the curve, 0.778). Body mass index and 24 hr urinary calcium excretion significantly affected random urinary calcium/creatinine ratio with a low coefficient of determination (r(2)=0.380, P<0.001). CONCLUSIONS: Random urinary calcium/creatinine ratio is not suitable for screening hypercalciuria in children with hematuria. Twenty-four hour urinary analysis should be performed to diagnose hypercalciuria in children with hematuria.

Excision of forehead osteomas: experience with 12 patients with use of an endoscopic technique.

Endoscopic excision of benign forehead masses has been previously reported on. A variety of pathology occurs on the forehead, and small-sized frontal bone osteoma is definitely a candidate for endoscopic surgery. The purpose of this study is to present our clinical experience with 12 consecutive forehead osteomas that were excised with the aid of an endoscope. With refinements in technique, the area of subperiosteal dissection was kept to a minimum; superficial ostectomy followed by smoothening of the frontal bone surface was efficiently performed. The patients' ages ranged from 20 to 67 years, and the diameter of the lesions varied from 0.8 to 2.2 (mean 1.1) cm. The mean operative time was 15 minutes, and there was no complication that required any other treatment. All the patients were satisfied with the final result. The authors have found that excision of forehead osteoma using an endoscope coupled with proper instruments to be very safe and effective with minimal morbidity.