diffuse growth. Types of growth in plants

Fundoplication is a surgical procedure used for gastroesophageal reflux. The concept of gastroesophageal reflux is a disease in which the contents of the stomach are thrown back into the esophagus. The purpose of the surgical intervention is to strengthen the esophageal-gastric sphincter by wrapping the walls of the stomach and esophagus.

The treatment of gastroesophageal reflux by fundoplication was introduced into medical practice by the doctor Rudolf Nissen in 1955. The first operation on the stomach had many shortcomings and consequences, but in the future, the technique was improved and modified.

Despite the fact that most modern gastroenterologists agree on a longer conservative treatment, there are indications that require radical surgical intervention. These include the following factors:

• Continuous conservative treatment, which does not give positive, visible results on the patient's condition. In this case, there is a constant symptomatology.
• When observing recurrent erosive esophagitis.
• When large sizes diaphragmatic hernia, contributing to the compression of other organs and systems in the body.
• The development of a characteristic anemia resulting from open microbleeding, which can be caused due to erosion or hernia.
• For precancerous condition. With Barrett's esophagus.
• If the patient is unable to carry out long-term drug therapy or due to individual sensitivity to proton pump inhibitors.

Possible contraindications

Surgery is not recommended for:

• During the period of acute infectious diseases, with exacerbation of chronic diseases;
• With decompensated heart, kidney, liver failure;
• In the presence of oncological diseases, at any stage;
• At diabetes, in a difficult stage;
• Finding a patient in a serious condition, exceeding the age threshold of sixty-five years;
• With a shortened, stricture esophagus;
• Weak peristalsis recorded due to manometry.

If the patient has no contraindications, the gastroenterologist prescribes a preoperative examination. Before surgical intervention The patient is advised to follow the prescribed diet food. The diet is aimed at the exclusion of foods rich in fiber, dairy products, fresh bakery products, black bread. After fundoplication possible flatulence, the diet menu helps to significantly reduce gas formation. The patient is advised to have a light supper; on the morning before surgery, eating is prohibited.

Survey

To relieve the symptoms of herb surgical process carried out only after careful medical examination. The gastroenterologist needs to make sure that the observed symptoms (presence of heartburn, belching, dysphagia, discomfort in the area chest) refers directly to reflux, and is not a consequence of another pathology.

Preoperative examinations include:

1. Conducting fibroendoscopy necessary to: confirm the presence of esophagitis; observation of non-closure of the cardia; fixing general condition structures, dilatation of the esophagus; exclusion of the development of neoplasms on the walls of the stomach and esophagus; confirmation of the presence of a hernia in the esophagus, fixing its size parameters and location.
2. Carrying out daily pH-metry of the esophagus, aimed at confirming the presence of refluxed stomach contents. This procedure is important in the absence of pathology after endoscopic examination and persistent symptoms.
3. Performing esophageal manometry necessary for: exclusion of achalasia of the cardia; assessment of esophageal peristalsis.
4. Carrying out fluoroscopy, necessary to clarify the location, size of the esophageal-diaphragmatic hernia.
5. Donation of blood, urine of the patient. Holding biochemical analysis blood.
6. Donating blood to detect chronic infectious diseases.
7. Conducting fluorography, ECG, visiting a therapist.

Fundoplication according to Nissen

One of the most used in medical practice The technique is considered a Nissen fundoplication. Nissen performed three hundred and sixty-degree esophageal wraps during the operation by wrapping the anterior and back wall bottom of the stomach, forming a circular cuff.

This antireflux method allows fully eliminate symptoms of herb. The disadvantages of the Nissen fundoplication are as follows:

• barrel clamp vagus nerve.
• Development of cascade deformity of the stomach.
• Torsion of the organ and esophagus.
• Observation of persistent dysphagia after surgery.

Doru fundoplication

The Dor fundoplication involves laying the anterior wall of the fundus of the stomach in front of the abdominal part of the intestine, after which fixation occurs along the right wall. At the first suture, the esophageal-diaphragmatic ligament is captured. This type of fundoplication is associated with the worst antireflux outcome. To date, the Dora fundoplication has gone out of medical practice.

Tupe fundoplication

André Toupet, like his predecessor Nissen, used the technique of isolating the esophagus by suturing the legs of the diaphragm. In this case, complete envelopment does not occur, since the fundus of the stomach is displaced, creating a fundoplication cuff not by three hundred and sixty, but by one hundred and eighty degrees. The Tupe technique involves a free anterior right side, which promotes the release of the vagus nerve. Subsequently, the method has undergone changes affecting the formation of the cuff at two hundred and seventy degrees.

Key Benefits this method are:

• A significant rarity of the formation of persistent postoperative dysphagia.
• Slight formation of gases leading to discomfort in the patient.
• Having a good burp, without difficulty.

From negative sides emit significantly lower antireflux properties than the Nissen technique. Tupe fundoplication is used in patients with neuromuscular abnormality, as there is a high possibility of recurrent dysphagia due to a failure in peristaltic contractility occurring in the esophagus.

Fundoplication according to Chernousov

The Chernousov technique is considered the most acceptable option. The operation is performed by forming a cuff of three hundred and sixty degrees, having a symmetrical shape. A method was developed based on the existing negative postoperative reactions, such as compression of the vagus nerve, twisting, deformation of the organ, and changing the position of the formed cuff.

An important feature of Chernousov's surgical intervention is that there is a return restriction. Surgery is not recommended for elderly patients.

The postoperative period, which proceeds without the presence of negative reactions, saves the patient from constant visits to the attending physician, the use of antisecretory, prokinetic drugs.

Performing open surgery

The above techniques involve surgery through open access, carried out under general anesthesia. The operation is performed according to the following methods:

• At the top abdominal wall an incision is made.
• The left hepatic lobe is shifted.
• The fundus of the stomach and part of the esophagus are prepared.
• An intraluminal stage is performed by inserting a bougie.
• The wall of the organ is put on the lower part of the esophagus in front and behind. The method should be concluded according to the chosen methodology. There is a formation of a cuff in length up to two centimeters.
• In the presence of a hernial defect, a cruroraphy is performed.
• The walls of the organ are stitched together with the capture of the esophageal part.

Fundoplication by laparoscopy and incisionless method

The essence of this surgical intervention is the formation of a cuff in the lower part of the esophagus. But the cut is not performed in this case. Access is made through punctures that introduce a laparoscope, with special tools.

The laparoscopic technique has little damage, little painful sensations, abbreviated postoperative period. The disadvantages of the method include the duration of the operation of more than thirty minutes, thromboembolic complications, the operation is paid.

In turn, American surgeons presented an innovative method - the transoral technique. Narrowing of the esophageal-gastric junction occurs through the use of staples driven through oral cavity sick. This significantly reduces the likelihood of negative postoperative consequences.

Diffuse changes in the structure of soft tissues can be in the form of atrophy, degeneration [fatty, fibrous (scar-adhesive process) or combined!, inflammatory infiltration. Focal changes in the structure of soft tissues look like cicatricial restructuring, limited inflammatory infiltrate, volumetric formations traumatic genesis (hematoma, seroma, cyst, neuroma), ectopic (heterotopic) ossificates. According to clinical and radiological research methods, their size, localization, contours, density are determined.

Diffuse changes in the soft tissues of the stump

Atrophy. There are several methods to objectively assess the degree of atrophy of the soft tissues of the stump.

Unlike clinical and functional research methods, based on the results radiodiagnosis it is possible to produce with high certainty:

• direct measurements and comparative analysis the thickness of the soft tissues of the proximal sections of the truncated segment and the skin-fascio-muscular flaps above the sawdust;
• assessment of the structure and homogeneity of tissues in strictly symmetrical areas of the limbs.

X-ray with atrophy, there is a thinning of the subcutaneous fat, a decrease in its density, a violation of the differentiation of soft tissues. The muscles look heterogeneous, spotting appears in the form of spindle-shaped areas of enlightenment in the projection of individual myofascial groups.

With ultrasound, a decrease in the thickness of tissues is determined, a change in their structure: multiple small hyper- and hypoechoic inclusions are visualized, the number of fibrous septa decreases.

The greatest information content in determining the degree of stump atrophy at the studied levels is given by SCT. It allows you to fix signs of minor atrophy, accompanied by thinning of soft tissues by less than 1/4 of their thickness compared to the original (with a healthy limb). If this ratio is 1/2, then the changes are classified as moderate.

Cases where the thickness of the soft tissues in proximal parts the stump is reduced by more than 1/2 compared with a healthy limb, are considered as severe atrophy. Using this research method, moderate atrophic changes in soft tissues are detected in 58.3% of cases and pronounced in 25% of patients with amputated limb stumps.

The skin-fascio-muscular flap over the bone sawdust deserves special attention. Its thickness should average 2.5-3 cm. In some cases, with significant changes, soft tissues in the coronal part of the stump appear only as skin and subcutaneous tissue, their thickness does not exceed 0.5 cm.

Situations that manifest moderate or significant atrophy of the soft tissues of the stump with their sharp thinning over the bone sawdust require a revision of the treatment tactics (surgical correction, changes in the principles of patient rehabilitation) in preparation for prosthetics.

Diffuse degenerative changes in soft tissues can be accompanied by both their thinning and thickening.

In the course of studies of the state of the stump during its formation and preparation for prosthetics, degenerative changes were graded into four types: muscle, fat, fibrous, and combined.

• muscle type the stump is characterized by a relative decrease in the volume of tissues, the absence of a violation of the differentiation of muscles and the subcutaneous fat layer of the truncated limb. Structural changes are manifested by cicatricial adhesions, well detected by ultrasound.
• fat type characterized by the presence of a narrow ring muscle tissue, enveloping the bone, and a pronounced subcutaneous fat layer. In almost 80% of cases, with this type of restructuring, the circumference of the stump decreases compared to a healthy limb at a symmetrical level.
• Stumps fibrous type have a cone-shaped or irregular shape, pronounced cicatricial adhesive changes in muscles, subcutaneous fat over a considerable extent. Soft tissues thicken, become thinner, become inactive, soldered to each other and to the bone. The volume of the stump usually decreases, it acquires a conical or irregular shape, only in 10% of cases these changes are accompanied by an increase in the thickness of tissues in the proximal parts of the stump and above the bone sawdust (up to 5-6 cm).

Diffuse inflammatory infiltration

On radiography, inflammatory infiltration is defined as a zone of increased density with loss of differentiation of all soft tissue structures. The shadow of the subcutaneous fat merges with the shadow of the muscles, their contour becomes fuzzy and uneven.

However, the listed signs cannot be considered as reliable criteria for inflammatory infiltration, they do not allow to accurately determine its severity, to obtain a spatial idea of ​​the localization and prevalence of the process. The most valuable information in these situations is provided by ultrasound and CT.

On echograms, diffuse inflammatory changes look like vast areas reduced echogenicity without clear contours, heterogeneous structure, accompanied by lymphoid edema of subcutaneous fat. The skin thickens up to 0.7-1 cm, while the inner contour of the dermis is not clearly visible. The echogenicity of muscle tissue decreases due to edema. Necrotic changes in individual muscles or muscle groups are also accompanied by a pronounced decrease in echogenicity and “blurring” of the ultrasound pattern. SKT-signs of diffuse inflammatory changes are manifested by thickening of the skin and subcutaneous fat with an increase in their density. In the muscles, zones of liquid or soft tissue density, heterogeneous structure with fuzzy and uneven contours can be traced. Air bubbles can be observed in the tissues, which are the result of revisions of purulent wounds.

Focal change in the structure of soft tissues

Focal cicatricial changes stump lower extremities occur in 80-85% of patients after amputations performed for injuries. They are characterized by the presence of areas of deformation and thinning of soft tissues that have arisen as a result of necrobiotic changes due to the mechanism of damage, high intersection of blood vessels and nerves, traumatization of tissues when using a prosthesis, etc. Besides, focal changes soft tissue structures appear to be limited inflammatory infiltrates, volumetric formations of traumatic origin, the most common of which are hematomas, seromas, false cysts, neuromas.

Abscesses in area postoperative wounds stumps are diagnosed in 23.3% of patients. The skin over the inflammatory infiltrate is thickened (up to 0.7-1 cm), with an indistinct internal contour, signs of lymphoid edema in the subcutaneous fat.

education fistula inflammatory processes on the stumps are accompanied in 10.8% of cases. On echograms, the fistulous tract is visualized as a tubular structure with even and clear contours, with reduced echogenicity.

Hematomas limb stumps after amputations performed due to injuries are observed in 20.4% of patients. On the first day after their occurrence, according to ultrasound in soft tissues amputated limbs, areas of reduced echogenicity are traced, more often irregular shape, with uneven, fuzzy outline. With prolonged existence of hematomas, heterogeneous echogenic parietal layers are located along their edge - areas of organization and formation of the capsule.

However, according to ultrasound data, it is impossible to accurately determine the amount of blood flowing and the size of hematomas. These characteristics could only be obtained from the results of SCT. Gradually, fibrin settles on the walls of the cavity in which the blood was located, a capsule is formed and the hematoma is transformed into gray and then in false cyst.

Revealing terminal neuromas refers to one of the most difficult tasks in assessing the condition of the stump before prosthetics and requires a particularly thorough standardized approach. There is no direct relationship between complaints and the presence of neuromas in patients with amputated stumps. In half of the cases, they exist as asymptomatic tumor-like growths of nerves associated with their damage and subsequent regeneration.

Only in 50-65% of cases, neuromas are accompanied by local or phantom pain, which occurs if the cut end of the nerve enters a scar, an inflammatory infiltration zone, or is squeezed when using a prosthesis.

As a result of the study of limb stumps after amputations performed for injuries, analysis, standardization and recording of the main semiotic signs of diseases and defects of the stump(an example of a standardized protocol for describing the state of the stump of the lower limb is given).

In multicellular plants, unlike animals, growth (with the exception of the early stages of embryonic development) occurs only in certain areas, which are called meristems.

Meristems are areas in a plant organism where regular reproduction occurs. plant cells. These zones are located apically, i.e., at the top of the growing organ (in the main and lateral shoots and roots), basipetally (in leaves and internodes), or intercalarly, for example, above the nodes in the salomine of cereals. Intercalary is an intercalary meristem (Table 6.1).

Between the leaf and the stem in the axils of the leaves, axillary buds are laid. axillary kidneys, which long time do not give shoots, are called sleeping; under certain conditions, they awaken and shoots develop from them.

Table 6.1. Types of meristems and their functions

meristem types	Location
Apical	At the tips of roots and shoots	Provides primary growth; forms the primary body of the plant
Lateral	In older plant parts, lies parallel to the long axis of the organ (cork cambium)	Provides secondary growth. The vascular cambium gives rise to secondary conductive tissues; periderm is formed, which replaces the epidermis and contains a cork
Intercalary	Between areas of permanent tissues, for example, in the nodes of many monocots	Does possible growth in length in the intermediate sections. This is typical for plants in which the apical areas are damaged (eating cereals by animals, etc.)

The lateral (cambium) meristem lies (parallel) along the long axis of the organ (eg, cork cambium) and provides thickening.

Internal physiological and biochemical reactions ensure the coordinated course of the growth process at all stages of life, determine the mechanisms of growth. Distinguish between primary and secondary mechanisms of growth.

The primary mechanisms of growth include physiological and biochemical reactions that underlie the initial stages of the growth process (lag phase) and the phase accelerated growth(logarithmic phase). The same mechanisms include electrophysiological, hormonal and genetic reactions that trigger and maintain the normal growth of cells, tissues and organs.

Secondary growth mechanisms are physiological and biochemical reactions that are involved in the normal course of growth (log phase and growth retardation phase) and occur during the life of plants. These include correlations between organs, donor-acceptor bonds, metabolic coordination between growth and other physiological processes(photosynthesis, transport, storage of substances, stress).

Thus, most often there are two types of growth: primary and secondary. Primary growth may result in a whole plant (for most annuals and herbaceous dicots, this is the only type of growth). It involves the apical and sometimes interpolar meristems.

In some plants, primary growth is followed by secondary growth, which involves lateral meristems. It is more characteristic of shrubs and trees. In a number of herbaceous plants, a secondary thickening of the stem is observed, for example, the development of additional vascular bundles in sunflower.

In addition, diffusion growth is also distinguished. This is growth during the division of all cells.



Diseases thyroid gland increasingly being diagnosed in people modern society. There are many reasons for this - both poor environmental conditions, and malnutrition and unhealthy lifestyle.

Diffuse enlargement of the thyroid gland is a change in the size of the organ evenly in all directions.

AT normal condition the thyroid gland is soft and quite difficult to detect when probing. However, with a small increase, it will also not be very noticeable. An accurate diagnosis can only be made by doctors after the examination.

Causes

A disease such as a change in the size of the thyroid gland in a big way also has its own reasons. These include:

• Bad environmental situation.
• Bad habits - smoking, alcohol and drug abuse.
• Wrong nutrition.
• Changes in hormone levels. And most often for this reason, diseases occur in women.
• Constant stress, nervous shocks.
• Lack of iodine in the body.

These reasons are the main ones. However, each person is different, so exact reasons only a specialist will determine the disease.

Symptoms

Every disease has its own symptoms. DUTC is also no exception. The main symptoms are:

• Change in the size of the thyroid gland. She gets bigger and tighter. On the early stages it's not that noticeable. Most often it is found on examination by doctors. The specialist can determine the change on palpation.
• In the analyzes, a change in the amount of thyroxine and triiodothyronine produced can be detected.

However, besides this, with problems in the activity of the thyroid gland, problems arise in the whole organism. Therefore, other signs can be observed. Here they are:

• Work disruptions occur nervous system. Man is constantly in depressed state. Often this disease is characterized by nervousness and irritation, insomnia.
• Fatigue increases, the person is constantly lethargic, he does not want anything.
• Decreased memory and attention. This is especially noticeable in children, it becomes difficult for them to learn and remember information.
• A person's heat exchange is disturbed, he is constantly cold.
• Problems in the work of the gland lead to the fact that human immunity is reduced, as a result, people often suffer from infectious diseases.
• In diseases of this organ, it primarily suffers the cardiovascular system. The pulse becomes very frequent, there are constant pressure surges. At the same time, dilated vessels in the hands can be noticeable in a person, and some skin diseases often appear.
• In addition, disruption gastrointestinal tract, which may be accompanied by constant constipation or, conversely, diarrhea.
• For diseases of the thyroid gland, such a sign as trembling in the hands is also characteristic. Often this phenomenon is diffuse goiter. It is difficult for the patient to hold a pen normally and sometimes even fasten buttons.
• Due to the disease, calcium metabolism may be disturbed, as a result, problems with bones and teeth may appear.
• Hair and nails suffer. The former begin to fall out strongly, the latter are characterized by excessive brittleness and fragility.
• Hormonal disruptions during illness lead to the fact that the reproductive function. Very often this is fraught with infertility, reduced sexual desire.
• Muscle soreness is also characteristic of DUTC.
• In addition, the hyperactivity of children can also indicate any violations in the activity of this important organ.

There are enough symptoms, but if any of them are found, there is no need to panic. An accurate diagnosis can only be made by a specialist and only after certain tests.

Degrees

Doctors divide diffuse enlargement of the thyroid gland into several stages. Here they are:

• Zero degree. In this case, the body is in a normal state. Its dimensions are not changed, and it is not palpable during examination.
• First degree. It is characterized by a slight increase, which is detected by palpation, when a person makes a swallowing movement. Doesn't show up in particular. The person does not experience pain. Doctors usually prescribe a blood test for hormones, which determines this condition. They also use ultrasound procedure. At this stage, it is used drug treatment, mainly use drugs that contain iodine. In addition, experts advise to follow a certain diet.
• The second degree is characterized by a change in the size of the gland upwards. This can already be determined visually. In addition, the lobes of the organ are easily determined by palpation. In this case, the neck is not yet deformed. This degree of disease is characteristic of diseases such as nodular goiter, oncological diseases, diffuse toxic goiter.
• In the third degree of the disease, the enlarged portions of the thyroid gland are already determined visually. The neck may change its shape. And when probing, you can determine how thick they are. Often at this stage of the disease, benign or malignant neoplasms. The most common treatment is medication.
• Fourth degree. This stage is the penultimate one. With it, in a person with the naked eye, a change in the contours of the neck is noticeable, an increase in its size, the lobes of the gland can be asymmetric. When palpated by a doctor, there are pain. In addition, for a person at this stage, a cough occurs, there may be a feeling of a lump in the throat.
• At the last fifth stage, the size of the thyroid gland is several times higher than normal. On palpation, there are sharp painful sensations.

Treatment

Treatment for diffuse enlargement of the thyroid gland depends on the stage of the disease. In addition, it is necessary to take into account in which direction the hormonal background could shift.

If hypothyroidism occurs, the doctor will prescribe medicines that contain the hormone T4. In hyperthyroidism, on the contrary, medications are used that inhibit the production of hormones. If the cause of an enlarged thyroid gland is not hormonal disbalance, then doctors most often leave this condition simply under observation. At the same time, the change in its size is monitored and the hormonal level is controlled.

If medical treatment fails, then surgery is used. In addition, the operation is used for big size thyroid gland and in cases where nodular neoplasms occur, the size of which is more than one centimeter.

If medical treatment does not help within two years, then most likely the doctor will also prescribe surgery.

Effects

Often people have a natural question about how dangerous an enlarged thyroid gland is. Any disease, if left untreated, can lead to negative consequences. This also applies to DUSC. For example:

• For the most part, the change in the size of the thyroid gland is the result of a violation of the hormonal level. And this is fraught with the development of many other diseases, impaired attention, memory, fatigue, increased cholesterol in the body.
• If time does not pay attention to the development of the disease, then it will only progress. And as a result, it will reach an irreversible level. As a result, a person will have to accept hormonal preparations for the rest of your life.
• If the disease is caused by a high content of hormones, then this also poses a great danger to humans. The fact is that with such a development of the disease, first of all, the heart and blood vessels of a person suffer.
• In addition, an enlarged gland has a negative effect on neighboring organs. A person may lose his voice, he may have problems with his voice and eating.

Prevention

To avoid diffuse enlargement of the thyroid gland, you need to follow a few simple rules:

• Proper nutrition. Often thyroid diseases develop as a result of iodine deficiency. Therefore, it is worth adding more foods containing this element to your diet. But from meat products, smoked meats, pickles, on the contrary, should be abandoned. At least for the period of treatment.
• Worth getting rid of bad habits, more is in the fresh air, avoid nervous shocks.
• If the cause of problems with the gland is a poor environmental situation, then you need to think about changing your place of residence, because your future life depends on it.

Enlargement of the thyroid gland can be cured if it is detected in time. Do not immediately panic if a specialist makes such a diagnosis.

Of course, you should not self-medicate, it is unlikely to give good results. It is best to follow all the recommendations prescribed by the doctor. In addition, if any symptoms are found, it is necessary to consult a specialist. After all, it is easier to cure a disease at an early stage than in an advanced state.

Quite often, in the results of an ultrasound examination, the term " diffuse changes thyroid gland”, however, what such a conclusion means is not deciphered.

Diffuse changes are a deviation in the ability of thyroid tissue to reflect sound during ultrasound diagnostics, due to pathological changes in the structure of the organ.

Thyroid disorders can be caused by:

• diseases of internal organs;
• a significant deterioration in the state of the environment in the region of the patient's residence;
• the presence of bad habits (smoking, drinking alcohol);
• lack of iodine in the body;
• decreased immunity;
• malnutrition;
• a significant number of stress factors, depressive conditions;
• harmful production factors;
• overweight and obesity;
• hormonal imbalance;
• endocrine diseases;
• autoimmune diseases.

The most common diffuse changes are caused by thyroiditis and various types goiter.

Signs of pathology

Diffuse changes are manifested as seals, heterogeneity in the structure of the tissue and the surface of the gland (while there are no focal anomalies), an increase in size, blurring and fuzziness of the contours of the organ, hormonal imbalance.

Growth in size and structural abnormalities can lead to the appearance of a goiter (diffuse or nodular).

Hormonal disorders appear in the form:

• hyperthyroidism (increased amount of gland hormones);
• hypothyroidism (low levels of hormones).

Sometimes hormonal abnormalities may be absent.

It is possible to determine that such a condition is observed in an individual by the following symptoms:

• hormonal disorders;
• depressive states, neuroses, psychoses;
• weight fluctuations not due to nutrition;
• reduced performance;
• constant feeling of aches and pains in the muscles, frequent chills;
• problems with bowel movements;
• decreased sexual function;
• decreased immunity (frequent colds);
• deterioration of hair, nails and skin;
• memory impairment, reduced concentration, intellectual abilities;
• chronic fatigue, weakness, lethargy.

Types of change

Diffuse changes in the thyroid gland are classified depending on the causes:

1. By type of thyroiditis:
   • changes in the type of autoimmune thyroiditis (by the type of AIT) - disorders caused by autoimmune thyroiditis;
   • changes in the type of chronic autoimmune thyroiditis (according to the type of HAIT) - disorders caused by chronic autoimmune thyroiditis;
   • disorders caused by acute thyroiditis;
2. Violations caused by various types of goiter.

Forms

There are several forms of diffuse changes:

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• Changes in the structure - a violation of the structure of the tissues of the organ (compaction and increase in volume). On the initial stages development, symptoms may be absent, deviations are detected during palpation by an endocrinologist. Hormonal disorders rarely appear in the initial stages of the disease.
• Nodular changes are a parenchymal neoplasm surrounded by a capsule that separates the healthy tissues of the organ from the node. The nature of the violation is to increase the follicles of the gland. A significant increase in nodes affects neighboring tissues and organs. Benign nodes can degenerate into malignant ones. Therefore, patients are recommended regular visits to the endocrinologist. The appearance of nodes can be a symptom of carcinoma, fibrocystic adenoma, nodular colloid goiter.
• Parenchymal change. The thyroid parenchyma is epithelial functional fabric; its structure is a set of vesicles (follicles) different sizes, around which are placed blood vessels. The function of these follicles is the production of the hormones thyroxine and triiodothyronine. With a diffuse change in the parenchyma, the size of the organ increases and, accordingly, the tissue of the parenchyma is disturbed; hormonal imbalances are often observed. This form of pathology can be detected during palpation.
• Diffuse-focal change - the occurrence in the tissues of the gland of areas with diffuse-heterogeneous changes in the structure. The tissue around such neoplasms has an unchanged structure. Foci with altered tissue structure can be cysts, teratomas, adenomas, paragangliomas, hemangiomas, lipomas, oncological neoplasms. Focal pathologies are characteristic of malignant and benign pathological processes: mixed goiter, nodular goiter, cancer, adenoma.
• Cystic changes - an increase in the size of the organ with the simultaneous formation of cysts in the tissues of the gland. Cysts consist of an outer capsule and a cavity filled with a fluid containing hormones (colloids). Purulent inflammatory processes can develop in cysts; these formations are characterized by the acquisition of a malignant nature.
• Pronounced changes are a significant increase in the size of the gland, which may be accompanied by the appearance of cystic or nodular neoplasms in the tissues, as well as disturbed hormonal balance. This type pathology is most common in autoimmune thyroiditis, and hyperthyroidism in Graves' disease (Graves' disease).
• Moderate changes - a slight uniform increase in the volume of the organ, without knots and seals, without deviations in the tissue structure. Hormonal imbalance is not observed. Similar symptoms have and hyperplasia of the thyroid gland with diffuse changes.

Diagnostics

Diffuse changes can be diagnosed during an ultrasound examination (according to echo signs) or during a planned visit to an endocrinologist, who, during palpation, analyzes the size, density and uniformity of the tissues of the organ.

The normal volume of the thyroid gland is 22 cm³ for men and 19 cm³ for women.

Ultrasound reveals the following echographic signs of diffuse changes:

• blurry fuzzy contours of the organ;
• heterogeneity of tissues (manifested by lighter areas);
• focal changes (nodular, cystic);
• impaired blood flow (increased or reduced);
• tissue echogenicity.

Reduced echogenicity is determined by the darker tone of the organ relative to the surrounding tissues and organs. Increased echogenicity appears as a lighter shade of gray on the screen of the ultrasound machine.

These echoes in the results of ultrasound are the reason for a more detailed study. Comprehensive examination includes tests for hormones: triiodothyronine, thyroxine, thyroid-stimulating hormone, and antibody titer.

Therapy Methods

Diffuse changes in the thyroid gland are not an independent diagnosis, but a conclusion based on the results of ultrasound about the presence of signs of disorders in the tissues of the thyroid gland. To establish the diagnosis and choose the tactics of therapy, it is necessary to consult an endocrinologist.

With an enlarged gland, preparations containing iodine (Potassium Iodide, Iodomarin, Iodide) are prescribed, and it is recommended to eat iodine-containing foods (legumes, eggs, herbs, processed cheese, seafood, buckwheat, seaweed and others).

Elevated antibody titers are indicative of an autoimmune inflammatory disease. In chronic autoimmune thyroiditis, the supervision of an endocrinologist is necessary. Women planning to conceive may need treatment.

At elevated level hormones are prescribed thyreostatics (Carbimazole, Thiamazole).

If the level of hormones is lowered, synthetic analogues of thyroxine and triiodothyronine (Levothyroxine sodium, Liothyronine) are indicated.

With a significant growth of the organ, compression of the surrounding tissues and organs may occur. In this case, it is necessary to apply operational methods treatment. In order to prevent the recurrence of the disease, synthetic analogues of thyroid hormones are prescribed.

Thyroid Disease Prevention

To prevent violations, you must adhere to the following recommendations:

• eat foods rich in iodine;
• avoid harmful production factors, negative impact ecology;
• adhere to proper nutrition;
• get rid of bad habits (smoking, drinking alcohol);
• avoid stress factors;
• carry out weight adjustment under the supervision of a gastroenterologist and nutritionist;
• make an annual preventive examination at the endocrinologist.

It still seems that it is not easy to cure the thyroid gland?

Given that you are now reading this article, we can conclude that this ailment still haunts you.

You must have also thought about surgical intervention. It is clear, because the thyroid gland is one of the most important organs on which your well-being and health depends. And shortness of breath, constant fatigue, irritability and other symptoms clearly interfere with your enjoyment of life...

But, you see, it is more correct to treat the cause, not the effect. We recommend reading the story of Irina Savenkova about how she managed to cure the thyroid gland...