[Benign thyroid nodule: what is the treatment? Personal experience]. / Tireopatia nodulare benigna: quale trattamento terapeutico? Esperienza personale.

INTRODUCTION: Solitary thyroid nodule is an important pathology with an incidence of 2-5% in the Italian population. The diagnosis was based on clinical exam, laboratory tests and ultrasonographic evaluation. MATERIALS AND METHODS: The study undertook has the purpose to assess the usefulness between lobe-isthmusectomy (with corresponding risk of possible relapse and complications for reintervention) and total thyroidectomy (with corresponding post-surgical treatment complications), for benign thyroid disease with solitary nodule, on selected cases for disease and corresponding risk factors, in the retrospective clinical study, using laboratory tests and ultrasonographic evaluation. The study was conducted on 80 patients admitted from 1994 to 2000 with diagnosis of benign thyroid nodule and operated with lobe-isthmusectomy. In seven patients the operation had to be converted in total thyroidectomy. RESULTS: Operative mortality was nil and long-term results at a mean follow-up of three years are encouraging. DISCUSSION: The main advantages of lobe-isthmusectomy for benign solitary thyroid nodule consist in less postoperative complications and less hospital stay. CONCLUSIONS: Therefore our experience has carried us to consider the lobectomy which treatment of choice for all those benign thyroid diseases with solitary nodule.

[Post-thyroidectomy hypocalcemia]. / La sindrome ipocalcemica in chirurgia tiroidea.

INTRODUCTION: The correlation between hypocalcemia and total thyroidectomy could be correlated to the influence practice from the TSH hormone on the thyroid C cells, in fact in conditions of hyperthyroidism the low values of the thyrotropin is correlated to a reduction of the plasmatic concentration of calcitonin and consequently of calcemia. of our study is verify the incidence of the hypocalcemia post-tyroidectomy and appraise the effectiveness of the pharmacological treatment with calcium salts and possibly D vitamin. MATERIALS AND METHODS: Of the 432 operated patients, 348 has stayed subjected to total thyroidectomy and 84 to loboistmusectomy. In none case subjected to emityroidectomy has been verified a hypocalcemia in the post-operative and in 67 cases in which we have administered pre-operative calcium salts orally, calcemia has sustained within acceptable values. RESULTS: Our experience only 1'11.2% of the patients subjected to total thyroidectomy they have presented a reduction of the calcemia to the of under of the 7.10 mg/dl and they have stayed subjected medical therapy with calcium salts in ev in the symptomatic forms, and to oral therapy in patients absent symptoms, while in two cases is not been practiced any therapy because the symptomatology has disappeared spontaneously DISCUSSION: Syndrome hypocalcemica has determined from the deficit-also transitory-parathyroid glands, from the action of the calcitonin (it favors the amassing of the calcium in to bon), and from a reduced bony reserve of calcium. In fact in those patients operated for a euthyroid goitre or for thyroid tumor the saving of the parathyroid glands avoids the outbreak of hypocalcemia (7, 8). Therefore the physio-pathological mechanism responsible of symptoms (excluded the medical causes: pharmacological treatments with steroid, oral conraceptives, diuretics, salts of lithium, oral antacid and diazepam) (9) also not being still of the all known, it would have his primum movens in the parathyroid glands ischemia. CONCLUSIONS: The precocious evaluation of the calcemia in the period post-operative is useful to discern the patients that will require of a pharmacological treatment of support, so that avoid of the serious and permanent damages to the varied organs.

Geomagnetic origin for transient particle events from nuclear reactor-powered satellites.

Transient events observed since 1980 by the Gamma-Ray Spectrometer experiment on the Solar Maximum Mission satellite (SMM) have been identified with radiation emitted from 18 different Soviet nuclear reactor-powered satellites. Most of these satellites are similar to Cosmos 954 and 1402 which reentered the atmosphere. Gamma radiation from these satellites was detected when they passed within about 400 to 500 kilometers of SMM. Positron annihilation line radiation (511 kiloelectron volts) and charged-particle events were detected when SMM encountered clouds of positrons and electrons emitted by these satellites and stored up to tens of minutes in the geomagnetic field. The rate of these events varied from about 1 in 5 days to over 30 per day and was strongly dependent on the operating altitudes of the Cosmos satellites and density of the upper atmosphere.