Cretin - who is this? The meaning of the word "cretin" in medicine and in colloquial speech

Brief information about the structure and functions of the thyroid gland

Cretinism is a disease that is associated with dysfunction of the thyroid gland. Therefore, to begin with, it will be useful to familiarize yourself with general information about the work of this body.

The thyroid gland belongs to the endocrine glands. It is adjacent to the cartilage of the larynx and consists of the right and left lobes, as well as the isthmus connecting them. The main hormones of this gland are thyroxine and triiodothyronine, the synthesis of which occurs only in the presence of a sufficient amount of iodine. In addition, this organ produces some other active substances, in particular calcitonin (a hormone responsible for calcium metabolism in the body).

The functioning of the thyroid gland also depends on the functioning of the hypothalamic-pituitary system in the brain. The pituitary gland secretes thyroid-stimulating hormone, which activates the synthesis of thyroid hormones. And the hypothalamus produces substances that control the functioning of the pituitary gland.

With the participation of thyroid hormones, processes such as:

• metabolism, breakdown of adipose tissue, synthesis and breakdown of protein molecules;
• the formation of energy, which is necessary for the functioning of muscles and the nervous system;
• increased blood glucose levels;
• work of the nervous and endocrine systems (thyroid hormones affect the work of other endocrine glands);
• transport of various substances to cells.

As the amount of thyroid hormones decreases, a disease called hypothyroidism develops. In turn, this disease can lead to the development of cretinism, myxedema and other disorders of the endocrine system.

Hypothyroidism and its types

In fact, there are many classification systems for this disease. Most often, children suffer from cretinism, since this disease is congenital. On the other hand, it can also be acquired - arise under the influence of certain factors.

Depending on the cause, there are several types of pathology:

• primary hypothyroidism, which is associated with dysfunction of the thyroid gland;
• a secondary form of the disease, which occurs against the background of malfunction of the pituitary gland;
• tertiary hypothyroidism, in which there is a violation of the normal regulation of the hypothalamus;
• impaired sensitivity of target cells (in such a situation, hormones are produced in sufficient quantities, but the cells are not sensitive to them).

A widely known form of the disease is endemic cretinism, a phenomenon that occurs in residents of regions with insufficient iodine.

Reasons for the development of pathology

The thyroid gland is perhaps the most important part in the structure of our body, although in terms of its size and location it stands modestly aside. We can say that if there were no thyroid gland, there would be no human being. The hormones produced by it provide all the important processes of intrauterine development of the fetus and the further development of the child. And first of all, it should be said about the formation of the brain.

Thyroid hormones ensure the formation and development of brain neurons. Among them are the cells of the cortical layer, which are responsible for human intelligence. In the first trimester of pregnancy, the auditory and motor centers are also formed. For the successful formation of all these cells, tissues and sections, it is necessary for the mother’s thyroid gland to function fully.

And its functioning can be disrupted for a variety of reasons.

:

• Lack of iodine and selenium in food;
• Viral infections;
• Smoking;
• Autoimmune diseases;
• The use of certain medications that suppress the thyroid gland;
• Radiation;
• Genetic disorders (in particular, this is observed in marriages between close relatives).

Thyroid hormones are also responsible for the growth and differentiation of body tissues. Weakening of this important organ is fraught with improper development of the skeleton, face, teeth, skin, and short human stature.

Selenium deficiency is one of the most terrible preconditions for thyroid diseases: with a deficiency of this element, the body is unable to absorb iodine.

It is curious that the thyroid gland is activated during the period of intrauterine development of the fetus. And diseases associated with disruption of its functioning may be congenital. The blood supply to this important organ is fifty times more active than the blood supply to the muscles.

Cases of cretinism, especially endemic, are quite common in the poorest countries of Africa and Southeast Asia, where there is poor nutrition, malnutrition and, in connection with this, a lack of nutrients, and the poor state of medicine also plays a role; This is especially true for countries that are landlocked (and therefore have no available sources of iodine). Insufficient amounts of iodine in food are also observed in the CIS countries, including Russia and Ukraine. It is characteristic that, according to international rules, salt for consumption today should be enriched with iodine, however, in the CIS countries, not all people use iodized salt (although it is not uncommon in stores). Various dietary supplements containing iodine are advertised in the media, but many are actually ineffective.

There is also “secondary” cretinism in adults, when the disease develops due to damage to the pituitary gland and hypothalamus. This can also happen as a result of operations on the thyroid gland or, for example, when the body receives radioactive iodine. Along with the usual signs of cretinism, myxedema develops - “mucoedema”. With this development of cretinism, the condition of a previously completely healthy person begins to deteriorate. His memory disappears, previously acquired knowledge and skills are lost, his character and behavior changes.

Various diseases of the thyroid gland can be more or less serious and scary, and cretinism is not the worst variant of hypothyroidism. The most terrible variant of the disease is the so-called myxedematous coma, which can be fatal. This disease is typical mostly for older women.

Cretinism: reasons

It’s worth saying right away that there are many factors that can lead to such a disease. As already mentioned, cretinism affects children who do not have enough thyroid hormones. And such a condition can be either congenital or acquired.

The causes of congenital hypothyroidism include:

• congenital underdevelopment or absence of the thyroid gland in the child;
• exposure of a pregnant woman to radiation or taking medications that reduce gland function;
• thyroid disease in the mother during pregnancy;
• genetic pathologies resulting in impaired iodine uptake by thyroid tissues;
• hereditary immunity of the gland to pituitary hormones;
• congenital diseases that disrupt the functioning of the hypothalamic-pituitary system.

In turn, acquired forms of the disease can also occur under the influence of various factors:

• insufficient amount of iodine in the diet of a pregnant woman or child;
• autoimmune thyroiditis;
• inflammatory processes in the thyroid gland;
• injuries or surgical interventions on the thyroid gland;
• trauma, inflammation and surgical interventions on the brain, which are accompanied by damage to the hypothalamic-pituitary system;
• brain tumors.

What is cretinism

Currently, this disease is commonly called congenital iodine deficiency syndrome. The term “cretinism” is considered obsolete, since the concept of “cretin” has long gone beyond the scope of medical “jargon” and moved into the street, acquiring offensive content. Nevertheless, the old term continues to be widely used by doctors - probably because of its brevity and conciseness.

Cretinism

is an endocrine disease that is caused by a lack of iodine and thyroid hormones. This disease manifests itself in a significant lag in mental and physical development.

In severe cases, the newborn may have no thyroid gland at all; in usual manifestations of cretinism it is present, but significantly reduced in size and weakened. In the complete absence of the thyroid gland, the child appears with congenital mental retardation, which, alas, cannot be overcome; in other cases, it is possible to compensate for the insufficient development of the thyroid gland by taking special medications.

Cretinism is a form of congenital hypothyroidism; This is a group of thyroid diseases.

Cretinism in children: what is the danger?

In fact, this disease is extremely dangerous, because thyroid hormones, to one degree or another, control the functioning of almost the entire body. So what consequences can the disease lead to?

Cretinism affects brain development, slowing it down. In particular, against the background of the disease, there is a disruption in the development of nerve fibers, as well as a decrease in the total number of neurons and the formation of substances that suppress brain activity.

Naturally, the lack of thyroid hormones also causes other disturbances in the functioning of the body, in particular:

• slowdown of growth processes;
• weakening of muscles;
• decreased formation of protein and energy compounds;
• disruption of skeletal development processes;
• disruption of hematopoietic processes;
• weakening of the immune system;
• disruptions in the functioning of the endocrine system, in particular the adrenal glands and gonads;
• disruption of the normal functioning of the kidneys, liver, intestines, stomach;
• dysfunction of the skin.

Naturally, if such problems arise in early childhood, then in the absence of treatment, disruption of the functioning of almost all organ systems is observed.

Causes of the disease

All causes of cretinism are to some extent related to a lack of thyroid hormones. These include:

• abnormal development of the thyroid gland in the embryo: abnormal location of the gland, underdevelopment or its complete absence in the fetus;
• use of drugs based on radioactive iodine by a pregnant woman;
• iodine deficiency in the body of the expectant mother;
• genetic causes causing dysfunction of the thyroid gland;
• consequences of endemic goiter suffered during pregnancy;
• Among other things, the cause of the disease can also be a marriage between close relatives.

Cretinism can be a congenital disease or develop as the child grows. Appropriate measures to treat the disease must be taken immediately after an accurate diagnosis has been established, so there is a much greater chance of overcoming defects in brain development and avoiding irreversible damage to a person’s physical and mental development.

The first signs of the disease in children

The only way to detect the disease in newborns is a blood test for the hormone. Cretinism practically does not appear in the first 2-3 months of life. However, the doctor may notice decreased appetite, difficulty breathing through the nose, frequent digestive problems, low heart rate, and large fontanelles on the skull that take a long time to heal.

As your baby grows, you may notice other, more serious symptoms. The child is slowly gaining weight, but looks plump, as he is prone to edema. Sometimes there is severe swelling of the tongue. The size of the head is disproportionate, as the body lags behind in development. Such children, as a rule, have a wide bridge of the nose and narrow eyes, as well as a short and thick neck. You can also notice some other disorders - the child is constantly drowsy, lethargic, and uncommunicative. As you age, you may notice mental retardation.

Symptoms of cretinism in adult patients

If left untreated, symptoms only worsen with age. People suffering from cretinism have very characteristic physical signs, in particular short stature and disproportion of body parts. Also characterized by constant swelling, clumsiness due to the structure of the body, clubfoot, impaired mobility in various joints. There are also special facial features, in particular a high forehead, large lips, wide cheekbones, a constantly protruding tongue, and protruding ears.

Almost all patients with a similar diagnosis suffer from mental retardation to one degree or another. Various hearing and speech impairments are also observed, sometimes up to deaf-muteness. Since the function of the gonads is reduced, infertility is possible. In addition, such people are lethargic, uncommunicative, apathetic and suffer from certain mental disorders.

Modern diagnostic methods

If you have any suspicions, you should immediately consult a doctor. Only a specialist knows what hypothyroidism is, the symptoms and treatment of which we are discussing today. An examination by an endocrinologist alone is not enough to make an accurate diagnosis.

To begin with, blood tests are performed to determine the levels of thyroid and pituitary hormones. By the way, some patients may develop so-called temporary hypothyroidism, so the tests are repeated after some time. Many clinics take blood from newborns for preventive studies.

In the future, an ultrasound examination of the thyroid gland is also performed, and, if necessary, Dopplerography and duplex scanning. These tests allow you to determine the size of the gland, the presence of enlargements, changes, neoplasms in the thyroid tissue, as well as the state of blood flow.

Children are also shown x-rays of bones, since skeletal ossification occurs slowly in children with this disease. If necessary, the patient is also examined by a therapist or pediatrician, neurologist, orthopedist, psychiatrist - doctors help identify the presence of complications and correctly draw up a treatment regimen.

What is “topographic cretinism” and how to deal with it

Author Editorial Board Pravda.Ru

22.09.2004 11:14

Health » Health and prevention » Psychotherapy

Many people are completely unable to navigate the terrain. This defect is popularly called “topographic cretinism.” How to deal with it?

Oleg Vasilyevich Lopatnikov, a physiologist from the St. Petersburg Institute of the Human Brain, advises.

It must be said right away that women suffer from “topographic cretinism” much more often than men. This is a clearly established scientific fact. It has been proven in repeated studies conducted by American, English, and German scientists. These included mazes, 3D graphics, and simple spatial awareness tests. And most women coped with this task worse than men. Those, as it turned out, also suffer from this deficiency. But the male percentage was significantly lower.

Interestingly, if the tests were carried out with a couple, then the woman voluntarily transferred the initiative to the man. She recognized his leadership in this area in advance. But when the unconfident “experimental subject” was left alone, she did everything that was necessary. Slowly, with mistakes, but nevertheless she did it. There were, of course, those who miserably failed all tasks. But I would like to immediately say that there were very few such people, even among women. From all this an absolutely logical conclusion follows: the fair half of humanity very much doubts their ability to navigate in space. Maybe this is where the reason for the failure lies? Maybe it’s worth mobilizing sometimes and trying to act on your own?

You need to know that there is a terrain view and a route view. The first is nothing more than a map that exists in our head. Those who suffer from “topographic cretinism” have great difficulty imagining this map. After all, such people do not have developed spatial imagination, and not since childhood. While studying at school, they went to geography or physics lessons as if they were going to hard labor. Drawing was torture for them. And when the course of plane geometry was replaced by stereometry, the unfortunate children stopped understanding anything at all.

If they had given maximum effort to this subject, then, most likely, they would not have suffered later. But this is just a guess. You wouldn’t advise them to take the stereometry course again.

There are special exercises for training the representation of the terrain. You need to open the map and study it carefully. Then you should take a pen, a sheet of paper and try to draw the segment of the path that you need to walk or drive. Here it is still necessary to distinguish who is studying the area and for what purpose. If a pedestrian wants to get to know an unfamiliar area, a medium-scale map is best. If it is too large, then the person will begin to be distracted by unnecessary details. But the main task is to familiarize yourself with the location of the streets, remember how they are located in relation to each other.

After studying, you need to take a pen and a piece of paper and try to draw a plan of the required area yourself. Then you need to compare your drawing with the original. If there are errors, they must be noted and remembered. They represent the most difficult part of the journey for that particular person. Then you need to take a new sheet of paper and again draw the street diagram preserved in your head. And so on until the plan on paper becomes an accurate representation of the map. Usually this does not take very much time - 10–15 minutes.

For drivers, the task gets a little more complicated. They need to remember not only the location of the streets, but also how to drive along them. You should remember both the area itself and the main signs. And you need to draw not only a street plan, but also the upcoming route. This activity is quite troublesome, but it brings very good results. Finding yourself in an unfamiliar area, a person will not feel lost.

We have dealt with the presentation of the area, all that remains is the presentation of the route. Usually there are no problems with this. The fact is that people with poor spatial imagination tend to have very good visual memory. Here it is necessary to highlight significant landmarks, by which you can then determine the correctness of the path. Interestingly, for men, such landmarks most often become cafes, restaurants and billboards. And for women there are clothing, cosmetics and lingerie stores.

Anna KRIVINA

Topics school

Discuss

Methods of treating the disease

Only a doctor knows what hypothyroidism is (symptoms and treatment of this disease, possible complications - all these points should be discussed with a professional), and only he can help you. Therefore, in no case should you neglect the advice of a specialist.

As a rule, patients are prescribed replacement therapy - they take hormonal drugs that replenish the deficiency of natural thyroid hormones. In particular, the drug “L-thyroxine” is considered quite effective. In addition, the treatment regimen may include vitamin complexes, nootropic drugs (“Cerebril”, “Piracetam”, “Nootropil”), as well as drugs to improve the functions, protection and nutrition of nervous tissues (“Lipocerebrin”, “Pantogam”, “ Encephabol").

An important component of treatment is a proper diet that will provide enough iodine. Depending on the patient's condition, the help of a neurologist or psychiatrist may be needed. In the future, the child must constantly undergo medical examinations and tests, based on the results of which the doctor will be able to adjust the treatment regimen.

What is the prognosis for patients?

Cretinism is an extremely dangerous disease, as it can even lead to disability. However, most often with early diagnosis and proper treatment, the patient can be helped. Normalizing the functioning of the thyroid gland and pituitary gland leads to the elimination of metabolic disorders.

However, complications cannot be avoided in all cases. For example, if therapy is started late, brain damage remains. And some genetic diseases are difficult to treat even with symptomatic treatment.

Are there effective methods of prevention?

It is worth noting that cretinism is an extremely serious disease that should never be ignored. With early detection and timely competent treatment, a lot of complications can be avoided. It is clear that many people are interested in the question of whether the development of the disease can be prevented.

There are some simple rules that experts recommend following. For example, in areas where this disease is common, general prevention should be carried out, in particular, monitoring the sufficient iodine content in food.

Since cretinism affects children who do not have enough thyroid hormones, it is extremely important to pay attention to this point at the stage of pregnancy planning. For example, parents are advised to get tested and undergo some tests for metabolic disorders and certain genetic diseases. In addition, a pregnant woman should carefully monitor the amount of iodine she consumes. It is also very important to carry out screening tests immediately after the birth of the child, because the sooner the disease is detected, the higher the likelihood of successful treatment before serious complications arise.

Colloquial version of the term

But people far from medicine have heard the word “cretin” more than once, perhaps even addressed to themselves. Imagine a person is late in submitting a report or a project in general. And his boss is not the most polite in the world. And so the employee goes to the manager’s office, and the manager asks him:

— Petrov, where is the finished project? Where is at least a report on the work done?

- Nikolai Ivanovich, I thought there was still time. You see, yesterday was my wife’s birthday...

- Petrov, tell me, are you a complete idiot or are you just pretending? What's your wife's birthday?! If you lose your job, you will have nothing to celebrate the holidays with! Understood?! Go. So that the project is completed by the evening, otherwise from tomorrow you will no longer work here!

It is not known whether Petrov coped with the task, but one thing is certain: his unfortunate fate helped us understand the meaning of the word “cretin” in its colloquial version. If someone needs clarification, then a cretin in the everyday sense is a narrow-minded, stupid person. Or someone who does not know how to correctly set priorities, make the right choice and gives the impression of an idiot, although he himself may not be a bad person and is not a fool at all. But circumstances developed in such a way that someone appeared in an unfavorable light, like Petrov from the example. Do you think he has a problem with his head? Nothing happened, he just loves his wife very much, but he can’t explain this to his boss. Now the question of who a cretin is should not arise. It remains to clarify some details.