PubMed Health⌕ Search

Biomedical subjects

A Haak

Publications and source records attributed to A Haak.

9 recordsLinked to original sources
PubMed1990

The natural history of euthyroid multinodular goitre.

In this communication data on the natural history of euthyroid multinodular goitres are presented. From a total group of 140 patients (mean age 54.6 years, 14 men and 126 women; 88 with autonomous, 52 with non-autonomous function), follow-up data were available for 90 patients (mean age 54.0 years, 11 men and 79 women; 64 with autonomous, 26 with non-autonomous function). During follow-up (means: 5.0 years, maximum 12.2 years) transitions in function were seen 15 times; 8 autonomous patients became hyperthyroid after less than 1-7 years. There were 6 transitions from non-autonomy to autonomy and 1 from autonomy to non-autonomy. One patient who demonstrated the whole cycle from non-autonomy through autonomy up to hyperthyrodism is described in more detail. In one patient operated upon because of hyperparathyroidism a follicular carcinoma was found by chance. Mechanical problems were the reason for surgery in 6 patients only, 16 patients were operated upon because of cosmetic reasons (mostly in the early years of the study). Finally, results from 19 TRH tests in 16 autonomous patients suggest that TRH tests in patients with autonomously functioning euthyroid multinodular goitres are not yet redundant.

Adult↗
PubMed1989

Disseminated histoplasmosis. Typical presentation with involvement of the adrenal glands.

A 67-yr-old Indonesian patient with disseminated histoplasmosis is described. He had general malaise and fever for 6 months; an oral ulcer, bilateral adrenal gland enlargement and partial adrenal insufficiency were found. An adrenal aspirate contained Histoplasma capsulatum. The literature on adrenal involvement in disseminated histoplasmosis is reviewed and it is concluded that bilateral enlargement, demonstrated by sonography or computed tomography, in a patient with general malaise is an important clue to the diagnosis.

Adrenal Glands↗
PubMed1989

Diagnosis and treatment of Graves' disease. Results of a survey of Dutch internists.

The results of a survey of Dutch internists on the diagnostics and treatment of Graves' disease is presented. Eighty-five per cent of all participants chose medical treatment for the uncomplicated patient. Radioiodine was reserved for the case of recurrence after medical treatment and after surgery. Surgical treatment was chosen almost exclusively for a larger goitre by 30% of the participants. Large differences in diagnostics and the treatment were not found between the three categories of hospitals: university, teaching, and general non-teaching hospitals.

Adult↗
PubMed1989

Treatment of hypothyroidism in The Netherlands. Results of a survey of Dutch internists.

The results of a survey on the treatment of hypothyroidism by Dutch internists, working in different types of hospitals, are described. Except in cases of cardiac complications or long-standing disease at old age most patients were treated in the out-patient clinic. About 50% of the internists chose 25 micrograms of levothyroxine as the initial dose for uncomplicated hypothyroidism. A lower dose (12.5 micrograms) was chosen by one-third of the internists working in teaching hospitals and general hospitals, while 36% of the internists working in university hospitals start with 50 micrograms of levothyroxine. For all variants of the basic case of uncomplicated hypothyroidism the dose was even lower. Adjustment of the dose was usually made at fixed intervals combined with measurement of plasma thyroid hormone levels and clinical parameters. The final substitution dose was generally based on the TSH levels. Anticoagulant drugs were seldom used except in cases of cardiac complications.

Age Factors↗
PubMed1979

Thyroid-stimulating immunoglobulins do not cause non-autonomous, autonomous, or toxic multinodular goitres.

Thyroid-stimulating immunoglobulins (TSIs) were measured by radioreceptor assay in serum from 51 patients with a multinodular goitre, divided into four groups according to thyroid function, and in 30 normal people. In 9 patients who were euthyroid and had non-autonomous thyroid function and in 6 patients who were hyperthyroid, TSI index was normal . Of 21 euthyroid patients with autonomous function only 2 had a slightly abnormal TSI index (66 in both, normal greater than or equal to 68). Another series of 15 clinically euthyroid patients also had a normal TSI index. These results suggest that TSIs do not contribute to the pathogenesis of multinodular goitre, as has been suggested by others.

Adult↗
PubMed1978

Normal prolactin response following thyrotrophin releasing hormone in patients with autonomously functioning euthyroid multinodular goitre.

Twelve female patients (mean age 60 years, range 41--74) with euthyroid multinodular goitre and a flat TRH test (median delta TSH 0.9 muIU/ml, range 0--3.5) had normal prolactin responses to TRH (median data prolactin 48 ng/ml, range 6--115). The results are comparable with those in euthyroid patients receiving full substitution doses of thyroid hormone without increasing T3 and/or T4 levels beyond the normal range.

Adult↗