THYROID ACROPACHY

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ULTRASOUND EVALUATION OF DIFFUSE THYROID DISEASES

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DIAGNOSIS OF THYROTOXICOSIS IN PATIENTS AGED OVER SIXTY

Fifty patients aged over 60 years (average age of 64,04 years) were studied. The thyrotoxicosis was proved in a clinical, laboratory, and in some cases histologic way. As a result of our investigation we established that the thyrotoxicosis in the elderly patients posed considerable diagnostic difficulties because of the atypical and olygosymptomatic clinical picture. The disease could be manifested by one symptom only which was tachycardia in most cases. One common symptom in our patients was atrial fibrillation. The presence of ischemic heart disease did not exclude thyrotoxicosis. Most often a depressive but not irritative syndrome was observed. The skin was soft and gentle but often cold and dry. The structure of the thyroid gland was established with ultrasonography and sometimes  radioiodine scanning. The TRH-test was of a significant diagnostic value and good acceptability in elderly patients which allowed to ignore the usage of Werner's test

T3-THYROTOXICOSIS

Twenty-five patients with T3-thyrotoxicosis were studied. The diagnosis was based on clinical observation, biochemical values, total T3 and T4, and ultrasound tests of the thyroid gland. A conservative treatment was carried out and where necessary a surgical one, too. The authors observed this form of the thyrotoxicosis in male as well as in female patients, the average age of the patients was young, and the duration of the disease from its beginning until diagnosing was longer than that of the common form. A bigger size of the thyroid was observed which was denser and often pseudonodular. In the clinical picture the cardio-vascular and neurological symptoms prevailed. Only in two cases light forms of thyrotoxic ophthalmopatia developed. The disease showed tendency towards relapses. Four patients were operated on because of difficulties in achieving a compensation of the euthyroid state and frequent relapses

HYPOGLYCEMIC CONDITIONS PRESENTING DIAGNOSTICAL DIFFICULTIES IN A DIABETIC FEMALE PATIENT

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SIDE EFFECTS OF TREATMENT WITH THYROSTATICS

The authors report their results from the study of 118 patients with thyrotoxicosis treated in Clinic of Endocrinology, Department of Endocrinology and Gastroenterology in 1996-1997. The treatment with thyrostatics has a number of side effects, most common of which are leukopenia, allergic reactions, and liver disorders. The complications depend on the dose of the drug, the duration of its application, the preliminary leukocyte count, and the state of the liver. The treatment with Propycil shows less frequent side effects than that with Metizol. With L-Thyroxin included in the therapy the goitrogenic effects and drug-induced hypothyroidism are prevented. Propycil (Solvay Pharma) is preferable because of its quicker initial and clinical effect in the treatment of thyrotoxic crisis, in pregnancy, and preoperative preparation

SCREENING OF THE THYROID PATHOLOGY IN THE POPULATION OVER 60 YEARS

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DIAGNOSTIC VALUE OF THYROID ULTRASONOGRAPHY IN THE COMPLEX EXAMINATION OF THYROIDITIS

Thyroiditis is a substantial part of thyroid pathology. Sixty-eight patients with thryroiditis were investigated hy means of real-time ultrasonography. Echographic data were analyzed according to the following diagnostic subgroups: acute suppurative thyroiditis, silent thyroiditis, subacute thyroiditis, and Hashimoto thyroiditis. Ultrasonography enabled the visualization of local changes in cases with acute inflammation of the thyroid gland and the differentiating the thyroid from the extrathyroid inflammatory processes. The typical diffuse or localized hypoechogenecity was a valuable sonographic feature of a possible subacute or Hashimoto thyroiditis. The relatively rapid normalization of echostructure during glucocorticoid treatment in cases with subacute thyroiditis was a specific ultrasonographic finding, while, however, there were no similar changes in patients with Hashimoto thyroiditis

QUALITY OF LIFE IN TYPE-I DIABETES MELLITUS PATIENTS WITH DIABETIC VEGETOPATHY

"Quality of life" represents one of the most important parameters of individual coping the problems of social adaptation in case of persisting manifestations of the basic disease. A total of 46 type I diabetes mellitus patients with diabetic vegetopathy were examined. Diagnosis was anamnestically and instrumentally verified. Patients' quality of life was investigated using MMP1 in a Kincannon's variant, Zungs depression scale, and Spitcer's quality-of-life scale. The following code was established: schizoidia - psychasthenia - hypochondria - paranoia. According to the depression scale, there was a slight depression in 51,7 per cent of the patients, a moderate - in 36,5 per cent but a severe - in 13,7 per cent. According to the quality-of-life scale, the parameter of self-confidence was characterized as poor in 17,3 per cent of the cases, moderately good - in 31 per cent but good - in 51,7 per cent. Social adaptation was poor in 6,8 per cent of the patients, moderately good - in 31 per cent but good - in 62,2 per cent. The correlation between the expression of vegetopathy, the severity of diabetes mellitus, the self-confidence, social adaptation and "social inertia" was discussed

CLINICAL AND CYTOGENETICAL STUDY OF A PATIENT WITH SYNDROME OF NO NN Е —MILRO V—-M ЕIGE COMBINED WITH SYNDROME OF LAURENCE—MOON—BARDET—BIEDL

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