Thyroid Diseases: Jukić T

Kusić Z, Jukić T, Dabelić N, Franceschi M, Anonymous00045. · Hrvatsko drustvo za stitnjacu, Klinika za onkologiju i nuklearnu medicinu, Klinicka bolnica, Sestre milosrdnice, Zagreb. · Lijec Vjesn. · Pubmed #19062757 No free full text.

Abstract: With the introduction of ultrasound and fine-needle aspiration biopsy at the beginning of 1980s, dramatic changes in the clinical perception of thyroid diseases happened, especially thyroid nodules and thyroid cancer. The prevalence of thyroid nodules in the population according to ultrasound findings ranges from 20-50%, while around 5% of thyroid nodules harbour cancer. During the past decades significant increase in the incidence of thyroid cancer was recorded worldwide, mainly due to increase in the incidence of papillary thyroid cancer, probably due to improved diagnostics. Many thyroid societies developed guidelines for the management of patients with differentiated thyroid cancer. An interdisciplinary team of experts of the Croatian Thyroid Society studied guidelines of other thyroid societies and international publications, and according to our tradition and clinical practice developed the Guidelines for the Management of Patients with Differentiated Thyroid Cancer. The guidelines were published at Croatian Thyroid Society web page--www.stitnjaca.org, for open discussion and recommendations. Finally, the guidelines were accepted.

Murgić J, Salopek D, Prpić M, Jukić T, Kusić Z. · Department of Oncology and Nuclear Medicine, University Hospital "Sestre milosrdnice", Zagreb, Croatia. · Coll Antropol. · Pubmed #19149242 No free full text.

Abstract: Clinical guidelines have been increasingly used in medicine. They represent a system of recommendations for the conduction of specific procedures used in fields from public health to different diagnostic and therapeutic procedures in clinical medicine. Guidelines are designed to facilitate to medical practitioners the adoption, evaluation and application of an increasing body of evidence and arising number of expert opinions regarding the presently best treatment and to help in delivering proper decision for the management of a patient or condition. Clinical guidelines represent a part of complementary activity by which research is implemented into praxis, standards are defined and clinical excellence is promoted in all health care fields. There are specific conditions which quality guidelines should meet. First of all, they need to be founded on comprehensive literature review, apart from clinical studies and trials in the target field. Also, there are more systems for analyzing and grading the strength of clinical evidence and the level of recommendation emerging from it. Algorithms are used to organize and summarize guidelines. The algorithm itself has a form of an informatic record and a logical flow. Algorithms, especially in case of clinical uncertainty, must be used for the improvement of health care, increasing it's availability and integration of the newest scientific knowledge. They should have an important role in the health care rationalisation, fight against non-rational diagnostics manifested as diagnostic procedures with no clinical indications, it's unnecessary repetition and wrong sequence. Several diagnostic algorithms used in the field of thyroid diseases are presented, since they have been proved to be of great use.

Jukić T, Dabelić N, Rogan SA, Nõthig-Hus D, Lukinac L, Ljubicić M, Kusić Z. · Department of Oncology and Nuclear Medicine, University Hospital "Sestre milosrdnice", Zagreb, Croatia. · Coll Antropol. · Pubmed #19149235 No free full text.

Abstract: The village of Rude is situated near Zagreb, the capital of Croatia in the last Alpine valley on Balkan. In the past, the village was well-known area of severe iodine deficiency disorders (IDD). In 1952', distinguished Croatian endocrinologist Professor Josip Matovinović carried out detailed village survey. Goiter prevalence in school-age children was 85.0% (with 2.3% of cretins in the village). In 1953, the first regulation on compulsory salt iodination with 10 mg of KI/kg of salt was established in former Yugoslavia. Ten years later a dramatic decrease in goiter prevalence was recorded in all endangered areas of the country and no new cretins appeared. However, at the beginning of 1990' mild to moderate iodine deficiency still persisted in Croatia. In 1991, the village of Rude survey demonstrated goiter prevalence in school-age children of 35.0% and median of urinary iodine excretion (UIE) of 7.4 microg/dL. In 1996, the new obligatory regulation with 25 mg of KI/kg of salt was established in Croatia. The study aim was to monitor IDD status in the village after the new law on compulsory salt iodination. Measurements of UIE and thyroid volumes (Tvol) by ultrasound were performed in 7-11-y-old schoolchildren living in the village of Rude. Medians of UIE and body surface area (BSA)-adjusted Tvol in boys and girls were calculated. The study included 84 children in 1997, 132 in 2000, 72 in 2002, 85 in 2003 and 46 in 2004 for UIE measurement. Thyroid volumes were measured in 1999 (43 boys and 26 girls) and in 2005 (22 boys and 26 girls). Data were compared with the new WHO/ICCIDD reference values. Medians of UIE in schoolchildren from the village of Rude demonstrated rising values in microg/dL: 11.4 in 1997, 14.3 in 2000, 17.3 in 2002, 15.4 in 2003 and 19.0 in 2004. Significant decrease in BSA-adjusted Tvol was recorded from 1999-2005 in boys and girls from the village of Rude and in 2005 Tvol were within the normal range according to the new international reference values for Tvol in iodine-sufficient schoolchildren. As a result of increased iodine prophylaxis, IDD no longer exist in Croatia. Monitoring of IDD status in the village of Rude after new law on compulsory salt iodination in Croatia demonstrated rising medians of UIE together with significant reduction of Tvol. In 2005, Tvol in schoolchildren from the village of Rude were within the normal range according to the new international reference values for Tvol in iodine-sufficient schoolchildren.

Kusić Z, Jukić T. · Department of Nuclear Medicine and Oncology, Sestre Milosrdnice University Hospital, Zagreb, Croatia. · Coll Antropol. · Pubmed #16117293 No free full text.

Abstract: At the time after the Second World War, endemic goiter was present in most parts of Croatia with a prevalence of more than 50% and presence of cretinism. In the village of Rude near Zagreb, goiter was detected in 85% of school children with 2.3% of cretins in the village population. In 1953 the first regulation on obligatory salt iodination, requiring 10 mg of potassium iodide (KI) per kg of salt was established in former Yugoslavia. A three-fold reduction of goiter prevalence, together with disappearance of cretinism was recorded ten years later In 1992, the National Committee for Eradication of Goiter was founded. The survey performed during 1991-1993 exhibited prevalence of goiter among school children between 8% and 35% and urinary iodine excretion under 10 microg/dL in most of the children from continental parts of the country. The new obligatory regulation, requiring 25 mg of KI/kg of salt, was proposed by the National Comittee and finally established in 1996. In 2002 thyroid volumes and medians of urinary iodine excretion were normal according to the ICCIDD criteria. Overall median of urinary iodine excretion for schoolchildren in Croatia was 14 ug/dL. Croatia crossed a path from severe iodine deficiency detected in the 1950's to the period of mild to moderate iodine deficiency during the 1990's, and finally, nowadays, iodine sufficiency has been achieved.