Iodine deficiency is still an important health care problem in the world. In Italy, as in most European countries, it is responsible for the development of mild to moderate endemic goiter. In 1995 we conducted a goiter survey in the Gubbio township, an area of Umbria region in Italy, close to the Appenine mountain chain. This study demonstrated a high prevalence of goiter in the middle schoolchildren population, indicating the presence of moderate endemic goiter. Soon after, a goiter prevention campaign aimed at implementing the consumption of iodinated salt was started. In 2001, a second survey was conducted in the middle schoolchildren (age 11-14 yr old) of Gubbio and neighbour townships. Eight hundred thirteen subjects were studied. Data obtained in 240 age-matched children, studied in the same area in 1995, were used for comparison to monitor changes 5 yr after the beginning of iodine prophylaxis. Thyroid volume was measured by ultrasonography. Gland volume was expressed in ml. A large population living in a iodine-sufficient area, previously reported by others, was used as control. Urinary iodine excretion was measured randomly in 20% of the children. The overall prevalence of goiter decreased between 1995 and 2001 from 29 to 8%. Goiter odds ratio (OR), corrected for age, was 4.0 (95% CI 2.8-5.9) for 1995 compared to 2001 (p<0.000). Mean thyroid volume in the matched populations was 7.6+/-2.5 ml in 1995 and 5.7+/-2.1 ml in 2001. Median iodine urinary excretion increased from 72.6 to 93.5 mug/l, at the limit of statistical significance. Living in a rural area, no consumption of iodized salt and familiarity for goiter represented independent risk factors for goiter development. This study was the first conducted in Umbria region and confirmed that an implementation campaign for iodized salt consumption is a simple and useful instrument to prevent endemic goiter and related diseases. A new survey to evaluate goiter prevalence in the same area 10 yr after the beginning of iodine prophylaxis is already planned.

Objetivo: relatar nossa experiência com a colocação e o uso do cateter venoso central de longa permanência (CVCLP), implantado através das veias do braço. Pacientes e Métodos: trata-se de um trabalho retrospectivo em que foram analisados 586 cateteres implantados em crianças com câncer, de janeiro de 1995 a dezembro de 1999, no HC I - INCA. Resultados: dos 586 CVCLP implantados em crianças com câncer, 91,5% foram inseridos através das veias do braço (536), 45 (8%) implantados no tórax e 5 (1%) em outros sítios. As veias de escolha para o implante do cateter no braço foram as braquiais. Os resultados em relação às complicações (infecção, obstrução, exteriorização do anel fixador, ruptura do cateter, migração, entre outras), foram similares àqueles da literatura quando implantados no tórax. Conclusão: recomendamos a colocação do cateter no braço como primeira opção para colocação de cateteres venosos centrais de longa permanência para crianças com câncer, uma vez que mostrouse mais seguro, confortável, esteticamente mais tolerável e permitiu maior mobilidade aos pacientes, quando em uso do cateter do que os implantados no tórax. Implicação clínica: propomos a opção da colocação do CVCLP no braço como a primeira escolha por acharmos ser mais segura, mais confortável e eficiente, do que os implantados no tórax, para as crianças com câncer, que necessitem de um acesso venoso por tempo prolongado.

Objectives: Describe the demographic variables, types of liver tumor, surgeries performed and survival children diagnosed with liver tumor undergoing surgical treatment.Method: A retrospective analysis was performed in patients with pediatric liver tumors undergoing surgical treatment, from January 2010 to December 2015 at the "General Oncology Hospital. Solon Espinoza Ayala”. Results: Data from our study reported a diagnosis of hepatoblastoma in 51.85% of all pediatric liver tumors; 50% are routine controls without evidence of disease, 14.28% have been completed clinical treatment, 21.42% died from a second primary diagnosis with metastasis, and another 14.28% (only surgery) who were not followed up because they were transfers from another health system; with respect to global survival it was 64%. The ages ranged from 0 to 15 years old with an average of 5.5. Conclusion: It is very important a timely detection and adequate treatment by a specialized center and trained professionals, liver surgery is a very important chapter for the treatment of liver tumors. The surgical approach with tumor-free resection along with multidisciplinary treatment is the goal for healing.

OBJECTIVES: Description of different types of surgeries performed most frequently by a Pediatric Oncologist Surgeon. METHOD: Retrospective analysis of pediatric patients with oncological pathology who underwent surgical treatment by a Pediatric Oncologist Surgeon in the city of Quito – Ecuador, from July 2005 to October 2016. RESULTS: For the present study, a total of 2075 surgeries were identied, classifying them according to areas of the body; resulting in the most demanded surgeries with 62.93% thoracic surgeries, secondly with 13.25% (275) were abdominal surgeries; neck surgeries occupy third place with 7.13% (148), fourth with 6.50% (135) skin-related surgeries; Inguinal region occupies the fth place with 2.31% (48), surgeries performed in the oral cavity in sixth place with 1.44% (30) and lastly with 6.40% (133) we nd several surgeries such as Catheter Picc Line ttings, excision and tumor biopsies of limbs, cleaning and surgical review of areas that are not mentioned before. CONCLUSION: In medicine it is important to an oncological pathology the timely detection and appropriate treatment by specialized and trained professionals in a given area. The lack of specialists in Pediatric Oncological Surgery is evident; in Quito - Ecuador during the years of the present study there was only one specialist who with his scientic contribution, surgical ability and multidisciplinary team in oncology improved the quality and lifestyle of patients and family members; In addition, with this study, a precedent is created in an area as delicate as cancer surgery of children.