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Biomedical subjects

B E Brownlie

Publications and source records attributed to B E Brownlie.

At least 19 recordsLinked to original sources
PubMed1979

A screening programme for congenital hypothyroidism: preliminary results.

Highly sensitive and precise radioimmunoassays for thyroxine (T4) and thyrotropin (TSH) in dried blood spots on filter paper cards have been developed and are used to screen newborn infants for congenital hypothyroidism. Blood spot TSH levels are measured in samples for which blood spot T4 levels fall in the lower 10 to 15 percent. There was a low recall rate of approximately one infant in every 550 screened. During a 17-month period 5225 infants have been screened for congenital hypothyroidism and two cretins have been detected. Due to very early diagnosis, both infants were commenced on T4 replacement therapy before the age of three weeks.

Congenital Hypothyroidism↗
PubMed1978

Subtotal thyroidectomy for thyrotoxicosis: a reassessment, including TRH responsiveness.

Thyroid function was assessed in patients treated surgically for thyrotoxicosis in Christchurch between 1965 and 1972. Seventy-eight of the 89 thyrotoxic patients were available for reassessment. Seventy-one were clinically and biochemically euthyroid. Seven patients had received radioiodine therapy for post-operative relapse and 10 patients were receiving thyroxine replacement therapy. At the time of the survey five patients were clinically thyrotoxic and two patients were hypothyroid and an additional nine patients had grossly elevated TSH levels. TRH tests performed on 31 clinically euthyroid patients with normal baseline thyroid parameters demonstrated that more than a third had excessive TSH responses consistent with reduced thyroid reserve and only one patient showed a lack of response consistent with persistent thyroid autonomy.

Adolescent↗
PubMed1978

Toxic autonomous thyroid nodule following neck irradiation.

A 37-year-old male with a history of neck irradiation in childhood presented with thyrotoxicosis due to an autonomous thyroid nodule. Adjacent to the nodule was a radiation scar from radiotherapy administered 35 years previously. Hemithyroidectomy was performed and histological examination excluded malignant change. Long term follow-up should continue to detect possible nodule formation in the contralateral lobe.

Adult↗
PubMed1978

Low dose lithium-carbimazole in the treatment of thyrotoxicosis.

Fifteen patients with thyrotoxicosis were treated with low dose sustained release lithium carbonate 400 mg, combined with carbimazole 40 mg daily, and the therapeutic response was followed over a two week period. This response was compared with that obtained in a similar group of patient treated with carbimazole alone. Li-carbimazole treatment brought about a fall in the mean total serum T4 of 57.4% compared with a drop of 32.8% in patients treated with carbimazole alone. The mean serum T3 fell by 69.4% in the Li-carbimazole group compared with 47.3% in the group treated with carbimazole only. No lithium adverse effects were encountered.

Antithyroid Agents↗
PubMed1977

The pituitary-thyroid axis following surgery for thyrotoxicosis: thyrotrophin-releasing hormone tests in diffuse thyroid hyperplasia and toxic uninodular goitre.

The pituitary-thyroid axis was assessed 1 month after surgery by thyrotrophin releasing hormone (TRH) testing in thirty thyrotoxic patients treated by subtotal thyroidectomy and eleven patients with toxic uninodular goitre. All toxic nodule patients gave essentially normal TRH responses and have remained clinically and biochemically euthyroid at follow-up. Only seven of the thirty subtotal thyroidectomy patients had normal TRH tests when assessed 1 month post thyroidectomy -sixteen patients showed increased response, six gave flat responses, and one showed an anomalous minimal response. Follow-up TRH tests 12 months postthyroidectomy have shown a tendency for TRH responsiveness to return towards normal, but two patients with flat TRH tests have required radioiodine for relapse and four TRH hyperresponders are currently receiving thyroxine replacement therapy.

Adult↗
PubMed1977

The placental transfer of propylthiouracil, methimazole and carbimazole.

The placental transfer of 35S-labelled methimazole (MMI), carbimazole and propylthiouracil (PTU) has been examined in the rat in late pregnancy and in patients undergoing therapeutic abortion. Although rapid equilibrium of fetal and maternal serum radioactivity (FS:MS ratio 1:1) occurred after iv administration of 35S-carbimazole or 35S-MMI in rats, a persistent fetal to maternal ratio of less than one was observed after 35S-PTU administration. Results from human studies after a single oral dose indicate that, as in the rat, the placenta appeared to be more permeable to 35S-MMI than to 35S-PTU as shown by the marked difference in fetal serum:maternal serum ratios and amounts accumulated in the fetus. Localization of radioactivity in the human fetal thyroid was also observed after administration of 35S-labelled MMI, carbimazole or PTU.

Abortion, Induced↗
PubMed1977

Thyroid vascularity--documentation of the iodide effect in thyrotoxicosis.

Thyroid vascularity was measured in 101 thyrotoxic patients by analysis of 99mTc pertechnetate thyroid flow studies obtained with a gamma camera--minicomputer system. The diffusely hyperplastic goitres tended to have higher vascularity than the toxic multinodular goitres, and many of the solitary toxic nodules had vascularity results within normal limits. Potassium iodide therapy, 60 mg b.d. for 10-14 days results in a dramatic reduction in thyroid vascularity in diffuse thyroid hyperplasia and toxic multinodular goitre but the effect on toxic nodules was marginal.

Humans↗
PubMed1976

Thyroid function following intravenous pyelography.

Thyroid function was assessed by total serum thyroxine, free thyroxine index and serum triiodothyronine immediately prior to intravenous pyelography in 105 female outpatients. The thyroid function tests were repeated two months later. Although all three parameters showed a statistically significant mean rise, the changes were small and not clinically significant. Two patients from the study population with a past history of thyrotoxicosis had a transient elevation in serum triiodothyronine but neither patient developed clinical features of hyperthyroidism.

Adult↗
PubMed1976

Lithium as an adjunct to radioiodine therapy for thyrotoxicosis.

16 patients with diffuse thyroid hyperplasia were given lithium carbonate (400 mg daily) for 1 week before and 1 week after a standardised 5 mCi therapy dose of 131I. A comparable control group of 16 patients were treated with 5 mCi of 131I without lithium therapy. The % retention of the therapy dose was measured in all patients at 7 days (168-hour 131I uptake). In the lithium-treated group the 24-hour 131I uptake showed no significant change after the first week of lithium therapy. The mean 48-hour protein-bound 131I, however, fell considerably from 1-21 to 0.55%/dose/1. The mean 24-168 hour % thyroidal 131I uptake drop was significantly less in the lithium group. These results show that low-dosage lithium therapy increases the retention of a standard-therapy dose of 131I. Lithium promises to be a useful adjunct to 131I therapy in patients with a rapid thyroidal iodine turnover and particularly in young patients where the total body-radiation dose must be kept to a minimum.

Adolescent↗
PubMed1976

Lithium associated thyroid disease--a report of 14 cases of hypothyroidism and 4 cases of thyrotoxicosis.

Thyroid function was assessed in 80 patients receiving long-term lithium therapy. Three of the 80 patients were biochemically hypothyroid and a further patient was receiving thyroxine for lithium associated hypothyroidism. A further eight patients had elevated TSH levels and eight patients had subnormal serum triiodothyronine levels. After a 24 month follow up period seven of the 80 patients have developed clinical hypothyroidism. One patient had elevated thyroid parameters and clinical features of mild hyperthyroidism. Additional clinical and laboratory data are included from seven patients with lithium associated hypothyroidism and three patients with lithium associated thyrotoxicosis who were not included in the survey population.

Adolescent↗
PubMed1976

Detection of vesicoureteric reflux using radionuclide micturating cystography.

Radionuclide micturating cystography (RMC) has been compared with the standard micturating cystourethrogram for detecting vesicoureteric reflux (VUR). Of 16 renal tracts with VUR radiologically classified as gross all had reflux demonstrated on RMC and in 15 of these the reflux reached the renal pelvis. Eight of the 12 renal tracts with moderate VUR and three of four with slight VUR were shown to reflux on RMC. RMC should prove valuable for following the course of patients with VUR treated surgically or conservatively because of the lower gonadal radiation dose resulting from this technique compared with the conventional radiological method.

Adolescent↗
PubMed1976

An evaluation of lithium as an adjunct to carbimazole treatment in acute thyrotoxicosis.

The rate of control of thyrotoxicosis during the first 2 weeks of treatment was documented in 63 patients. Twenty-three patients received carbimazole 40 mg plus lithium carbonate 750 mg daily and a comparable group of 20 patients were given carbimazole 40 mg plus potassium iodide 120 mg daily. In the lithium treated patients the mean percentage fall of serum T4 after 2 weeks treatment was 49% and the fall in serum T3 57%. The results were similar in the iodide treated patients; the mean falls in serum T4 and T3 being 47% and 64%, respectively. Serum lithium values varied between 0.1-1.25 mEq./l; lithium side effects were minor. In a companion study 20 patients were treated with carbimazole alone. The responses in this group were less impressive; the mean falls in serum T4 and T3 at 2 weeks being 18% and 36%, respectively. It is concluded that lithium is a safe adjunct to conventional antithyroid drug therapy in the initial treatment of acute thyrotoxicosis.

Acute Disease↗