Incidence Of Nodular Goiter Research Articles

A combined nano-carbon tracer and nano-fluorescence assay for parathyroid misresection reduction in thyroid surgery

In recent years, the incidence of nodular goiter and thyroid carcinoma (TC), as well as the amount of surgery, have been increasing simultaneously. To summarize the significance and experience of combined nano-carbon tracer and nano-fluorescence assay for parathyroid misresection reduction in thyroid surgery. The data of patients who underwent thyroid surgery from November 2016 to July 2017 in the Thyroid Disease Diagnosis and Treatment Center of the Tenth People’s Hospital of Tongji University were collected and divided into test group (combined nano-carbon tracer and nano-fluorescence assay method, 80 cases) and a control group (nano carbon tracer method, 80 cases). Comparison of the patient data and preoperative and postoperative blood calcium, blood phosphorus, PTH value in the control and test group was performed. No significant difference was found on gender, age, preoperative Calcium, Phosphorus, Magnesium and PTH, postoperative Calcium, Phosphorus and Magnesium was found in the control and test group (all the p > 0.05), whereas significant difference was found on the postoperative PTH between control and test group (p < 0.001). Moreover, significant reduced number of parathyroid misresection was found in the test group compared to the control group (p = 0.003). Significant difference could be found on pre- and postoperation data of blood Calcium, Phosphorus, Magnesium and PTH in both control and test group (all the p < 0.05). A combined nano-carbon tracer and nano-fluorescence assay can be used in thyroid surgery, which is helpful to distinguish parathyroid tissue, avoid accidental injury or missection of parathyroid gland as much as possible, and reduce the incidence of postoperative hypocalcemia.

Clinical-statistical analysis of pregnancy and labour in women with nodular goiter

The incidence of nodular goiter in pregnant women occupies one of the leading places and constitutes from 30 to 40%, which, in its turn, produces unfavourable effect on the health of mother and fetus. Objective: to study the course of pregnancy, labour and condition of newborns born to women with nodular goiter. Material and methods. Clinical-statistical analysis of the course of pregnancy, labour and condition of newborns born to 60 women with nodular goiter (the main group) was carried out. The control group included 20 healthy pregnant women. Results. The analysis of the course of pregnancy demonstrated that its complicated development was found in 48 (80%) women of the main group and 1 (5%) – in the control one. In the control group in 100% of cases the outcome of pregnancy was labour, and in the main group – in 54 (90%) women. In patients of the main group, complications in labor were significantly more frequent (p <0,05). The data of the cardiotocography, the biophysical profile of the fetus and doplerometry testified to the deterioration of the intrauterine fetus in the main group. It was found that the lower an average level of free thyroxin in mother’s organism is, the lower is the score of the fetal condition (р<0,05). Assessment of the results of ultrasound and histological examinations of placentas enables to consider thyroid pathology as a risk factor promoting the development of placental dysfunction. Conclusions. Pregnancy in women with nodular goiter is often complicated with a tendency to miscarriage against the ground of hormonal imbalance. Nodular goiter available is a risk factor promoting the development of placental dysfunction. Fetal condition is in direct dependence on the level of thyroid hormones in mother.

Thyroid cancer

The prevalence of nodular lesions of the thyroid gland (thyroid gland), according to various researchers, ranges from 3 to 7%]. The widespread introduction of ultrasound (ultrasound) in clinical practice, as well as the results of autopsy studies, showed that the prevalence of nodular lesions of the thyroid gland is much higher and is about 50%, especially at the age of over 50. In women, thyroid nodes are detected 2-4 times more often than in men. Children suffer from nodular lesions extremely rarely. The incidence of nodular goiter is directly proportional to age. The increase in the incidence of nodular goiter is approximately 0.1% per year at a young age and gradually reaches 2%. The prevalence of thyroid cancer (thyroid cancer) among nodular goiter, according to various authors, is from 1 to 6%. It should be noted that the prevalence in the population of nodular goiter is so high both in the regions of iodine deficiency and with normal iodine supply, but in the first case it is slightly higher. The incidence of thyroid cancer in absolute terms does not depend on the level of iodine supply. Thus, in a situation of a slightly higher incidence of banal nodular colloid goiter in the regions of iodine deficiency, the proportion of cancer among all cases of nodular goiter will be less. It is important to note that these data make it possible to equally use the results of studies on thyroid cancer obtained in regions with different iodine supply.

Nodular goiter and thyroid cancer in children and adolescents living at the territories of Kaluga district contaminated with radionuclides

Thyroid status of children and adolescents living in the Kaluga district at territories contaminated with radionuclides after the Chernobyl accident was followed up from 1986 to 1994. Clinical studies included examination by endocrinologist, ultrasonic examination of the thyroid and regional lymph nodes with fine needle aspiration biopsy of thyroid tissue, if indicated, and measurements of blood serum levels of thyrotropin, thyroxin, triiodothyronine, thyroglobulin and autoantibodies to it, and of antibodies to the microsomal fraction of thyrocytes. Special attention was paid to the detection of nodular formations in the thyroid and identification of their type. The diagnoses were verified at Medical Radiology Research Center of the Russian Academy of Medical Sciences in the town of Obninsk. In 1994 an increase in the incidence of nodular goiter was observed in the cohort of children followed up. Four cases of thyroid cancer (follicular and papillary forms) were diagnosed in 1993-1994 among subjects exposed to radioactive iodine in childhood after the accident. Three of these patients were examined and treated at the Medical Radiology Research Center. Detailed excerpts from their case histories are presented.