A damned soul with goiter. "The life of Christ" (c. 1480) by Giovanni Martino Spanzotti.

The church of San Bernardino in Ivrea (Piedmont) houses a cycle of frescoes of "The Life of Christ" by the Italian painter Giovanni Martino Spanzotti. In the painting, a damned soul of the Hell with a large bi-lobar goiter is represented, confirming the interest of Renaissance artists towards thyroid diseases.

Goiter drawing in Ulrich Boner's Der Edelstein Codices Palatini Germanici 794.

We provide an example of representation of thyroid swelling in the artwork of Ulrich Boner's Der Edelstein Codices Palatini Germanici 794.

A goitrous model for Bartolomeo Vivarini (1432-1499).

INTRODUCTION: Bartolomeo Vivarini (Venezia 1432c.-Venezia 1499c.) was an Italian painter during the Renaissance. The artist was widely influenced by Andrea Mantegna, whose opera was characterized by personages with anatomical details meticulously described. MATERIALS AND METHODS: Some of the most valued paintings of Bartolomeo Vivarini were analyzed. Purpose of the present article is to describe these artworks focusing on female personages represented with thyroid swelling. RESULTS: A recurring female model in Vivarini's artworks is portrayed with a goitrous neck. This might display a real prevalence of thyroid diseases among young women in the Renaissance age (e.g. postpartum thyroiditis). CONCLUSIONS: Representation of goiter in the artworks of Vivarini and Mantegna reflects the increased anatomic accuracy and knowledge developed in art since Renaissance and Baroque.

Will the shepherd be able to play the alpine horn with that huge goiter (XVI century)?

PURPOSE: There are many of the representations in iconography of individuals with goiters reported in the literature. METHODS: The article describe a unique representation of goiter, as observed by the authors in a sculpture in Italy. RESULTS: In a Nativity, in the upper part of the altar of the Church of the Annunciata, Boccioleto (Val Sermenza, Piedmont, Italy), a horn player with a huge goiter, gladdens the Holy Family. Wooden work by Francesco Antonio d'Alberto, 1694. CONCLUSION: This is an appropriate example of the iconography of "real goiter," since in this case the sculptor had the aim of showing person with goiter.

Correlations of water iodine concentration to earlier goitre frequency in Sweden-an iodine sufficient country with long-term iodination of table salt.

BACKGROUND: Before iodination of Swedish table salt in 1936, iodine deficiency resulting in goitre and hypothyroidism was common. Sweden has become iodine sufficient, as shown in a national survey in 2007, proving its iodination fortification programme effective for the general population. The objective of this study was to collect drinking water from water treatment plants nationally and test if water iodine concentration (WIC) correlated to urinary iodine concentration (UIC) of school-aged children in a national survey 2007 to former goitre frequency in 1929 and to thyroid volume data in 2007. METHODS: In 2012, 166 treatment plants, located in 57% (166 of 290) of all Swedish municipalities, were asked to collect drinking water samples of approximately 10 ml. In 2007, tap water samples of the same volume were collected from 30 randomly selected schools for the national survey. Analysis of WIC was done in both treatment plants in 2012 (n = 166) and tap water in 2007 (n = 30). The correlation of WIC to the children's UIC and thyroid volume after iodination was tested based on data from the national survey in 2007. The association of WIC to former goitre frequency was tested based on pre-iodination data, derived from a map of goitre frequency drawn in 1929. RESULTS: The median WIC from water treatment plants was 4.0 µg/L (range 0-27 µg/L). WIC was similar in coastal and inland areas, for both ground and surface water. WIC correlated with historical goitre areas and was lower in the goitre areas than in non-goitre areas (p < 0.001). WIC in the same municipalities as the schools correlated with the UIC of children (p < 0.01), but not with their thyroid volume. CONCLUSIONS: WIC still contributes to iodine nutrition in Sweden, but iodination overrides the goitre effect.

The art of surgery.

, Published online in Wiley Online Library (www.bjs.co.uk). DOI: 10.1002/bjs.10863 In times when art usually depicted perfection, Caravaggio (1571-1610) painted everyday reality. He used people walking the streets of Rome to represent holy figures. Caravaggio loved many women. He killed a man in a duel and had to flee from Rome to avoid being 'beheaded by anybody who saw him'. In this biblical scene he painted, Judith Beheading Holofernes, Judith is a portrait of Fillide Melandroni, the reason for the duel. Holofernes is a self-portrait. Judith looks cruel, in mourning clothes, seeking revenge for the assassination of her lover. The maidservant, almost an evil spirit, has a voluminous thyroid goitre, and she seems to encourage the revenge of Fillide. Read more about Caravaggio and this painting in an essay online.

Thyroidectomy Then and Now: A 50-Year Australian Perspective.

BACKGROUND: Since the mid-1800s, thyroidectomy has transformed from a procedure associated with high to near-zero mortality. Nonetheless, surgeons must continue to strive to improve patient care. Using historical records and contemporary data, this study compares the practice and outcomes of thyroid surgery at a tertiary institution during two periods, 50 years apart. METHODS: 'The Alfred Hospital Clinical Reports' recorded all cases of surgically managed thyroid disease from 1946 to 1959. These historical cases were compared to contemporary thyroidectomy cases at the Alfred Hospital from 2007 to 2016. Cases were compared for surgical indication and post-operative outcomes. RESULTS: There were 746 patients in the historical group (mean age 53 years; 87% female) and 787 patients in the contemporary group (mean age 52 years; 80% female). The most common indication for thyroidectomy in both groups was non-toxic nodular goitre. A greater proportion of the contemporary group were diagnosed with thyroid malignancy (27% vs. 8%; p < 0.001). The contemporary group recorded significantly fewer cases of thyrotoxic crisis (2.1% vs. 0%; p = 0.001), permanent nerve palsy (4.6% vs. 0.4%; p < 0.001) and bilateral nerve palsy (1.2% vs. 0%; p = 0.01). There were no mortalities in the contemporary group, while the historical data recorded three deaths (0.44%). CONCLUSIONS: This study compared thyroid surgery in two cohorts separated by a 50-year period. While it is not surprising that outcomes of thyroidectomy have improved, this study uniquely demonstrates trends of thyroid surgery over time and areas in which further improvements may be made.

Evidence of an ancient (2000 years ago) goiter attributed to iodine deficiency in North America.

The Adena pipe figurine was found in the 2000 year-old Adena burial mound in Ross County, Ohio, USA by William C. Mills in 1901. The pipe reportedly represents an achondroplastic dwarf male Native American. However, the clinical aspect (swelling of the neck), the environmental/cultural characteristics in this area (iodine-poor soils, absence of seafood and milk consumption, tobacco smoking), and the marked prevalence of goiter among Native American populations favor the diagnosis of a goiter associated to iodine deficiency. Similar indigenous art representations found in South America and Mesoamerica strengthen this hypothesis. To our knowledge the Adena pipe is the first example of goiter depicted in Native North American art and one of the oldest from the continent.