ABSTRACT
The authors analyze the diagnostic value of thyroid palpation method (two modifications) comparing its results with those of ultrasonographic volumetry. The study involved 118 children aged 5 and 14 of both sexes living in regions endemic for goiter. The thickness of thyroid isthmus was found virtually the same no matter how greatly the gland was enlarged. The results proved the necessity of age-specific corrections in the criteria of current interpretation of palpation data: the first degree in preschool children was most often indicative of thyroid hypertrophy whereas in the pubertal age it was just a variant of normal size. Interpretation with due account of these amendments improved the reliability of diagnostic value of palpation, its sensitivity being 63 +/- 6, specificity 67 +/- 6, and accuracy 65 +/- 4%. When the results of palpation are adequately interpreted, the examinees' age and sex and the method of examination proper do not influence the data accuracy. The sensitivity of palpation in detection of nodules up to 10 mm in diameter proved to be null (in 6 of the 81 examined adolescents sonographic signs of encapsulated formation were seen in the thyroid). Bearing all this in mind, the authors discuss differentiated approaches to management of children and adolescents with the first degree of palpated enlargement of the thyroid.
Subject(s)
Goiter/diagnosis , Palpation , Thyroid Gland/diagnostic imaging , Adolescent , Age Factors , Child, Preschool , Female , Humans , Hypertrophy/diagnosis , Male , Predictive Value of Tests , Puberty/physiology , Sensitivity and Specificity , Thyroid Gland/pathology , UltrasonographySubject(s)
Cryptorchidism/complications , Family , Infertility, Male/prevention & control , Adolescent , Adult , Child , Child, Preschool , Chorionic Gonadotropin/therapeutic use , Cryptorchidism/diagnosis , Cryptorchidism/therapy , Humans , Infertility, Male/etiology , Infertility, Male/therapy , Male , Testis/surgerySubject(s)
Androgen-Insensitivity Syndrome/surgery , Anxiety, Castration/etiology , Orchiectomy/adverse effects , Vagina/abnormalities , Adolescent , Age Factors , Androgen-Insensitivity Syndrome/diagnosis , Androgen-Insensitivity Syndrome/psychology , Anxiety, Castration/prevention & control , Child , Child, Preschool , Diagnostic Errors , Female , Humans , Male , Orchiectomy/psychology , Sex Determination Analysis , Vagina/surgerySubject(s)
Blood Glucose Self-Monitoring , Diabetes Mellitus, Type 1/drug therapy , Insulin/administration & dosage , Blood Glucose/analysis , Child , Delayed-Action Preparations , Diabetes Mellitus, Type 1/blood , Dose-Response Relationship, Drug , Drug Therapy, Combination , Fasting/blood , Humans , Insulin/blood , Time FactorsABSTRACT
The experience with the treatment of more than 5140 children at the age of from 2 days to 16 years, and 76 patients at the age of from 15 to 42 years with different diseases of the genital organs and disorders in the sex formation is presented. The indications for surgical treatment are defined. The results of the masculinizing operations, including the phalloplasty and testicular endoprosthesis, and the feminizing ones, including the vaginoplasty with the use of a colonic segment are presented.
Subject(s)
Disorders of Sex Development/surgery , Genital Diseases, Female/surgery , Testis/surgery , Vagina/surgery , Adolescent , Adult , Child , Child, Preschool , Female , Genital Diseases, Male/surgery , Humans , Infant , Infant, Newborn , Male , Prostheses and Implants , Testis/abnormalities , Vagina/abnormalitiesSubject(s)
Chorionic Gonadotropin/therapeutic use , Cryptorchidism/drug therapy , Pituitary Hormone-Releasing Hormones/therapeutic use , Age Factors , Child , Child, Preschool , Chorionic Gonadotropin/administration & dosage , Cryptorchidism/blood , Humans , Infant , Inguinal Canal , Injections , Male , Pituitary Hormone-Releasing Hormones/administration & dosage , Time FactorsABSTRACT
The study confirmed the data on the absence of a stable compensation of diabetes mellitus in most patients with the insulin-dependent form of disease under domestic conditions. It was extremely difficult to maintain the state of compensation without active participation of patients instructed in therapeutic measures and control of disease. Therefore the most urgent problems of modern diabetology are to train patients, to encourage their participation in a therapeutic process and to provide facilities for determination of glycemia under domestic conditions.
