Objective: Multinodular goiter is a common surgical disease. There is no common consensus regarding the extent of thyroidectomy for multinodular goiter. This  study aims to present personal experience on treating patients with multinodular goiter and to compare complication rates and results of total and partial thyroidectomy for multinodular goiter. Material and Method: Three hundred fifty patients underwent thyroidectomy for multinodular goiter between May 2003 and October 2010. All patients were diagnosed as multinodular goiter and were referred to surgery by one endocrinologist. All operations were also performed by one surgeon using microsurgical techniques. Partial thyroidectomy (bilateral subtotal or unilateral total thyroidectomy and contralateral subtotal thyroidectomy) was performed in 65 patients (Group-1) and extracapsular total thyroidectomy was performed in 285 patients (Group-2). All patients are being followed followed from the day they were diagnosed until now by the same endocrinologist. Fisher exact test was used for statistical analysis. Results: In Group-1, one patient had transient vocal-cord palsy and but none had hypoparathyroidism. On the other hand, in Group-2, two patients had transient vocal-cord palsy, five had hypocalcemia (one was permanent), and one had a hematoma. Mortality and wound infection were absent in both groups. The histopathological studies showed that 40 incidental thyroid carcinomas occurred among Group-2 patients. During long-term follow-up, 13 patients had goiter recurrence (n = 65, 20%) in Group-1, whereas none had goiter recurrence in Group-2. Conclusion: There were no statistically significant differences in the complication rate between subtotal and total thyroidectomy groups (p>0.05). However, the recurrence rate was higher (statistically significant) after subtotal thyroidectomy than after total thyroidectomy (p<0.05). Total thyroidectomy eliminated future recurrence of the disease and is also curative in incidental thyroid carcinomas. In addition, it can be safely performed using microsurgical techniques.

In this study, we planned to investigate the effects of L-thyroxine monotherapy on total thyroidectomized patients. The main goal of our study is to evaluate if FT4 therapy is good enough not only to maintain euthyroidism but also to provide a good quality of life and a balance in their metabolism Methods: In this study, we retrospectively evaluated 30 total thyroidectomized patients without malignancy. We compared their thyroid hormone levels, glucose metabolism, lipid metabolism, their body mass indexes, and their symptoms of thyroid problems before surgery and after one year of treatment of L-thyroxine monotherapy.Results: the pre-op and post-op thyroid hormone levels were both in the normal range but the FT4 levels were significantly higher in the 1st year results than pre-op results (1,42 ± 0,18 vs 1,29 ± 0,49 respectively P=0,005*) The FT3 levels also were in the normal range in pre and 1st year post-op but post-op FT3 levels were significantly lower than pre-op levels (2,25 ± 0,27 vs 2,92 ± 0,49 retrospectively P<0,001*). The pre-op and postop TSH levels were euthyroid and not statistically significant. The patients tended to gain weight and it seems to be because of a tendency of being insulin resistant. (HOMA-IR pre-op and post-op were 2,2 ± 1,1 vs 2,6 ± 1,1 P<0,01 retrospectively; pre-op and post-op weights were 69,8 ± 9,5 vs 71,1 ± 10,3 P=0,006* respectively). Even all of them were euthyroid the patients tended to feel hypothyroidism symptoms. Conclusion:This study demonstrates that even though they are euthyroid with FT4 treatment total thyroidectomized patients may suffer from hypothyroidism signs and symptoms and metabolic deterioration may occur in such patients. We recommend that we should aim not only to normalize s-TSH levels but also to normalize patients' metabolic parameters and improve the quality of daily life when regulating our treatments.

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Objective Our study aimed to evaluate the perinatal and neonatal outcomes of hypertensive pregnant women with or without proteinuria. We compared the predictivity of spot urinary protein to creatinine (P/C) ratio and 24-hour protein excretions on outcomes. Methods We retrospectively enrolled 230 pregnant women with a new diagnosis of hypertension between 20 and 37 weeks of gestation. We divided the patients into two groups according to the protein level determined by 24-hour urine collection and P/C ratio. The presence and level of proteinuria, its relationship with the P/C ratio, and the relationship between these findings and perinatal outcomes were evaluated. Results Gestational age at delivery weeks and latency period (duration between diagnosis of hypertension and delivery) were significantly earlier in pregnant women with ≥300 mg/24-h and P/C ratio ≥0.3. Adverse neonatal outcomes were significant in patients with proteinuria ≥300 mg/24-hour and P/C ratio ≥0.3. Urinary protein levels in 24-hour urine were significantly higher in pregnant women with P/C ratio ≥0.3 and a significantly positive correlation was found between 24-h proteinuria and P/C (r=0.382, p<0.001). Conclusion Our study demonstrated that a protein loss of ≥300 mg in 24-h and a P/C ratio in spot urine ≥0.3 in hypertensive pregnant women is associated with adverse perinatal outcomes. Furthermore, we have identified that proteinuria ≥300 mg/day and spot urine P/C ratio ≥0.3 in hypertensive pregnant women make them prone to early delivery risk.