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Biomedical subjects

B Nygaard

Publications and source records attributed to B Nygaard.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Thyroid stimulating antibodies in pregnant women with Graves' disease and neonatal thyrotoxicosis].

Thyroid stimulating antibodies (TSAb) are thought to be involved in the initiation of Graves' disease, and thyrotoxicosis in the neonatal period is often caused by TSAb passing the placental barrier. We wanted to evaluate measurement of TSAb levels as a possible predictor of neonatal thyrotoxicosis in pregnant patients with Graves' disease. We retrospectively evaluated 18 consecutive pregnant patients with Graves' disease. In 16 patients TSAb were measured in early pregnancy, six had increased values. In 14 of 18 patients normal values were found in late pregnancy and none of the children developed neonatal thyrotoxicosis. Two patients had greatly elevated TSAb values, and their children had neonatal thyrotoxicosis. Two patients had slightly elevated TSAb levels and delivered normal children. We conclude that all pregnant patients with an actual or a history of Graves' disease, should have measured TSAb. High TSAb values in late pregnancy indicate a considerable risk of neonatal thyrotoxicosis.

Adult↗
PubMed1997

Thyroid volume and function after 131I treatment of diffuse non-toxic goitre.

OBJECTIVE: Traditional treatment of diffuse non-toxic goitre are thyroid hormone suppression or surgery. When treating nodular non-toxic goitre with 131I treatment a reduction in thyroid volume to about 50% has been observed. In the present study we evaluated the effect of 131I treatment of diffuse non-toxic goitre. DESIGN: Retrospective study of patients treated for a diffuse non-toxic goitre and followed by evaluation of thyroid volume measured by ultrasound. PATIENTS: Ten selected patients from our out-patient clinic with diffuse non-toxic goitre. MEASUREMENTS: Thyroid volume was measured by ultrasound and thyroid function by serum values of T4, T3, T3 uptake ratio, TSH, TSH receptor antibodies and thyroid peroxidase antibodies (anti-TPO). Measurements were performed before and 1, 3, 6 and 12 months (and 18 months (n = 7), thyroid volume measured in six patients)) after 131I treatment. RESULTS: Thyroid volume declined in all patients from median 41 (range 27-160) ml to 20 (range 9-108) ml over 1 year, a reduction of 47%. One patient developed transient and one persistent hypothyroidism in the follow-up period. Both had elevated anti-TPO levels before treatment (331 and 9185 U/ml) and demonstrated titre increases of 2.5 and 30 times after 3 and 6 months, respectively. Pretreatment values were reached after 1 year. The other eight patients had normal anti-TPO levels and free T4 and T3 indices did not change during follow-up, whereas serum TSH levels demonstrated upward trends within the normal range (P < 0.05). TSH receptor antibodies were normal and remained so in all patients. CONCLUSIONS: 131I treatment of diffuse non-toxic goitre reduces thyroid volume by approximately 50% within 12-18 months. Hypothyroidism, during a limited follow-up period, developed only in patients with positive anti-TPO levels before treatment.

Adult↗
PubMed1997

Thyrotropin receptor antibodies and Graves' disease, a side-effect of 131I treatment in patients with nontoxic goiter.

The use of 131I treatment in patients with benign nontoxic goiter is increasing, and the described side-effects are few. In this paper we describe appearance of TSH receptor antibodies (TRAb) and concomitant development of hyperthyroidism as a side-effect of 131I treatment in patients with nontoxic goiter. In this retrospective study, 191 consecutive patients with 131I-treated nontoxic goiter are described. Nine patients (5%) developed hyperthyroidism 3 months after 131I treatment, and 5 patients (3%) developed radiation thyroiditis within the first month. Frozen sera were analyzed for thyroid peroxidase antibodies (anti-TPO) in 130 patients before 131I treatment. In 21% of these, serum levels of anti-TPO were over 200 U/mL. The complication frequency of Graves'-like hyperthyroidism and hypothyroidism was 51% in patients with elevated anti-TPO (n = 27) and 15% in patients with normal serum anti-TPO levels (P < 0.00005). TRAb, anti-TPO, and thyroglobulin were followed in patients developing hyperthyroidism or radiation thyroiditis and in 10 control patients remaining euthyroid. At the time of 131I treatment, all patients had serum TRAb values within the normal range. Three months after administration of 131I, the patients developing hyperthyroidism had a transient extensive rise in serum TRAb and anti-TPO levels parallel to a rise in the serum free T4 index. In patients developing radiation thyroiditis, serum TRAb values were normal. In control patients, serum TRAb and anti-TPO values were both within the normal range throughout the observation period. In conclusion, hyperthyroidism can be triggered by 131I in patients with nontoxic goiter, not only related to radiation thyroiditis but also as a Graves'-like hyperthyroidism induced by TRAb. Elevated anti-TPO pretreatment is a marker of an increased risk of side-effects to 131I treatment in nontoxic goiter.

Adult↗
PubMed1996

Interaction between microwave-induced brain hyperthermia and high dose rate radiation in the BT4 An brain glioma in rats.

The cerebral BT4An glioma model in BD IX rats was used to study the effect of hyperthermia given in combination with radiotherapy (thermoradiotherapy) in the treatment of brain tumours. A single treatment with high dose rate radiation was given to a local brain field. Local brain hyperthermia was given at 42.4 degrees C for 45 min by externally applied microwaves (700 MHz), immediately before radiotherapy (10 Gy). In a pilot study, thermoradiotherapy increased the median life span with 20 days compared to controls, which was significantly better than that observed after radiotherapy alone (7 days). In an extended experiment the corresponding figures for thermoradiotherapy, hyperthermia alone and radiotherapy alone were 12.5, 3.5, and 3.5 days, respectively. Thermoradiotherapy was significantly better than radiotherapy and hyperthermia alone. There was no acute mortality in these experiments. Neurological side-effects were infrequent, of slight degree and reversible. The present study shows that a survival benefit of adding hyperthermia to radiotherapy can be achieved without unacceptable neurological side-effects in an animal glioma model.

Animals↗
PubMed1996

Improvement of upper airway obstruction after 131I-treatment of multinodular nontoxic goiter evaluated by flow volume loop curves.

Symptoms of tracheal-esophageal compression are often related to a large nontoxic goiter. The aim of the present study was to evaluate to what degree upper airway obstruction, as measured by flow volume loops, FIF50% and FEF50%/FIF50% (Forced Expiratory Flow at 50% of the vital capacity/ Forced Inspiratory Flow at 50% of the vital capacity) exists in nontoxic multinodular goiter, and whether changes occur after 131I-treatment. Thirteen patients with large multinodular nontoxic goiters were evaluated by estimation of FIF50%, FEF50%/FIF50% ratio and a graphic plot of the flow volume loop curve before and three, six and 12 months after treatment with 131I. FIF50% increased over 12 months from median 1.79 l/sec (range 1.46-3.02) to 2.84 l/sec (1.13-5.69) (p = 0.01). A progressive increase was seen over time (p = 0.001, trend analysis). The FEF50%/FIF50% ratio decreased from in 1.45 (0.32-2.26) to 1.03 (0.43-2.13) 12 months after treatment (p < 0.001). A progressive decrease was seen over time (p = 0.001, trend analysis). By visual evaluation 11 had a flow volume loop curve typical for an upper airway obstruction and in 9 patients the FEF50%/FIF50% ratio was > 1.2. In conclusion we found that upper airway obstruction is present in patients with multinodular nontoxic goiter, and seems to be reduced after 131I-treatment. Flow volume loop curves and measurement of FEF50% and FIF50% are important estimates for upper airway obstruction in these patients.

Aged↗
PubMed1996

Marked hepatotoxicity associated with losartan treatment.

Losartan represent a novel approach in the treatment of hypertension. Clinical trials have reported a very low incidence of side effects. We describe two patients who developed increases in alanine/aspartate amino transferase of 8 and 15 times the upper normal limit, as well as thoracic pain, after a short time of treatment with losartan. The increase resolved after discontinuing losartan treatment.

Angiotensin Receptor Antagonists↗
PubMed1995

[Does Iodine 131 treatment of goiter result in an acute increase of the volume and function of the thyroid gland?].

Many textbooks claim that radioiodine (131I) treatment should be avoided in treatment of a goitre with substernal extension, due to fear of acute swelling of the gland with resulting respiratory problems. We examined patients with multinodular goitre, either nontoxic (n = 20) or toxic (n = 10) after treatment with 131I. An ultrasonically determined thyroid volume and thyroid function variables were investigated before and two, seven, 14, 21, 28 and 35 days after treatment. In nontoxic goitres the thyroid volume did not increase significantly, the maximum increase in the median volume being 4% on day 7. Serum levels of free T3 and free T4 indices increased by 20% (day 7) and 13% (day 14) (p = 0.002), respectively. Likewise thyroid volume in toxic nodular goitre did not change significantly after 131I treatment. None of the patients presented symptoms of tracheal compression. We conclude that 131I treatment of nontoxic as well as toxic multinodular goitre does not seem to increase thyroid volume.

Adult↗
PubMed1995

[False results on elevated triiodothyronine values in radioimmunoassay].

Five patients with falsely elevated serum triiodothyronine (T3) concentrations (> 9 nmol/l) in a radioimmunoassay are reported. The high T3-values disagreed with the other thyroid variables investigated as well as with the clinical observations. In sera from all patients a normal non-specific binding of T3 was found, thus excluding abnormal serum-protein-binding of the hormone. An ethanol extraction of T3 from serum before RIA reduced the T3 content in serum from all patients to normal levels (2.0-2.4 nmol/l). These findings indicate the presence in the sera of substances, probably of protein nature, that were interfering with the assay by binding the reagent-antibody and not the antigen. Addition of non-immune rabbit serum prevented this interference and normalized the T3-values (1.8-2.4 nmol/l). Thus the interfering substance in T3-RIA could be an anti-rabbit antibody, the interaction of which can be eliminated by a minor modification of the assay making it possible to differentiate true from false T3-values.

Adult↗
PubMed1995

[Problems in thyroid function screening using thyroid stimulating hormone. A case of thyrotoxicosis caused by a thyroid stimulating hormone-secreting pituitary tumor].

UNLABELLED: In a new consensus report from the Danish Society of Internal Medicine a sensitive TSH assay is recommended for screening for thyroid diseases. A patient with thyrotoxicosis, normal serum TSH and a TSH-secreting pituitary adenoma is described. Other reasons for discrepancies between thyroid clinical status and serum TSH are mentioned: Target organ resistance to thyroid hormone, interference in the radioimmunoassay with heterophilic antibodies and insufficient production of TSH because of pituitary disease. IN CONCLUSION: Screening with TSH is acceptable, but if any discrepancy between TSH values and the clinical picture is found, further tests must be made.

Adenoma↗
PubMed1995

Is calculation of the dose in radioiodine therapy of hyperthyroidism worth while?

OBJECTIVE: The persistent controversy as to the best approach to radioiodine dose selection in the treatment of hyperthyroidism led us to perform a study in order to compare a fixed dose regime comprising doses of 185 370 or 555 MBq based on gland size assessment by palpation only, with a calculated 131I dose based on type of thyroid gland (diffuse, multinodular, solitary adenoma), an accurate thyroid volume measurement, and a 24-hour 131I uptake determination. DESIGN: Prospective randomized study. PATIENTS: Two hundred and twenty-one consecutive hyperthyroid patients referred for 131I treatment. Four Patients who died for reasons unrelated to hyperthyroidism, 7 lost to follow-up and 47 who did not receive antithyroid drugs after treatment, were excluded. The remaining 163 patients (143 women) were studied, divided into subgroups according to the type of gland. They all received antithyroid drugs prior to 131I treatment and this was resumed 7 days after treatment for a period of 3 weeks. MEASUREMENTS: Thyroid function variables were determined approximately 2 weeks before 131I treatment, and again 1, 2, 3, 6, 9 and 12 months after treatment. Prior to 131I therapy the size of the thyroid gland was determined by ultrasound and a 24-hour uptake of 131I was carried out. Thyroid volume was also estimated 12 months after 131I therapy in 78 of the 163 patients. Twelve months after the initial 131I dose patients could be classified as euthyroid, hyperthyroid or hypothyroid. RESULTS: Neither in the group of 163 patients nor within the three subgroups of hyperthyroidism could any significant difference in outcome between the two treatment regimes be demonstrated. Thirty-two of 78 patients (41%) in the calculated dose group and 30 of 85 patients (35%, NS) in the fixed group were classified as hyperthyroid. Seven of 78 (9%) in the calculated dose group and 6 out of 85 (7%, NS) in the fixed dose group were classified as permanently hypothyroid. Finally, 39 of 78 (50%) in the calculated dose group and 49 of 85 (58%, NS) in the fixed group were euthyroid at 12 months after 131I treatment. One year after 131I therapy thyroid volume was reduced from 59.3 +/- 9.2 (mean +/- SEM) to 36.2 +/- 6.6 ml (average reduction 39%) in the calculated dose group (P < 0.001). This reduction did not differ significantly from the fixed dose group where thyroid volume declined from 61.6 +/- 6.1 to 41.17 +/- 4.7 ml (average reduction 32%) (P < 0.001). CONCLUSIONS: A semiquantitative approach is probably as good as the more elaborately calculated radioiodine dose for treatment of hyperthyroidism. It is clearly more cost effective and allows the use of predetermined standard doses.

Adult↗
PubMed1995

Influence of compensated radioiodine therapy on thyroid volume and incidence of hypothyroidism in Graves' disease.

OBJECTIVES: To investigate the long-term effect of radioactive iodine (131I) on thyroid function and size in patients with Graves' disease. SETTING: Out-patient clinic in Herlev Hospital. SUBJECTS: One hundred and seventeen consecutive patients (104 women) with Graves' disease selected for 131I treatment and followed for a minimum of 12 months (range 1-10 years, median 5 years). INTERVENTIONS: 131I dose was calculated based on thyroid volume and 24-h 131I uptake. MAIN OUTCOME MEASURES: Standard thyroid function variables and ultrasonically determined thyroid volume before treatment as well as 0.75, 1.5, 3, 6 and 12 months after treatment, and then once a year were investigated. RESULTS: Seventy-eight patients were cured by one 131I dose and 30 by two doses, while the remaining nine patients received additional doses (range one to five doses, median one dose). Within one year, 25% developed hypothyroidism, and hereafter, hypothyroidism developed at a constant rate of 3% per year independent of antithyroid pretreatment. The cumulative 10-year risk of hypothyroidism was 60%. Initial median thyroid volume was 33 mL (range 9-106 mL). At 12 months after the last 131I dose, median thyroid volume was reduced to 14 mL (range 6-36 mL) (P < 0.00001). The median reduction being 58% (range 0-80%), hereafter no further reduction occurred. A significant reduction in thyroid volume was also noted in patients needing subsequent 131I doses and in those developing hypothyroidism within the first year. CONCLUSIONS: 131I normalizes thyroid volume in patients with Graves' disease. Hypothyroidism seems an inevitable end result of this treatment. The present study suggests that it will be impossible to modify 131I therapy in a way to achieve both early control of hyperthyroidism and a low incidence of hypothyroidism.

Adult↗
PubMed1994

[Long-term effect of 131I therapy of multinodular non-toxic goiter].

The aim of this study was to investigate the long term effect of 131I treatment on thyroid function and size in patients with non-toxic multinodular goitre. The subjects were 69 consecutive patients with multinodular non-toxic goitre selected for 131I treatment and followed for a minimum of 12 months. Outcome measures were standard thyroid function variables and ultrasonically determined thyroid volume before and after treatment. Fifty-nine patients were treated with a single dose of 131I, 12 with two doses, and one with four doses. In 45 patients treated with one dose who remained euthyroid the median thyroid volume was reduced from 73 (interquartile range 50-106) ml to 29 (interquartile range 23-48) ml at 24 months. The median reduction was 40 (22-48) ml, half of which occurred within three months. Patients treated with two doses as well as those developing hypo- or hyper-thyroidism also had a significant reduction in thyroid volume. Eleven patients developed hypothyroidism (cumulative five year risk 22%). Side effects were few. In conclusion we find that 131I treatment of multinodular non-toxic goitre is an attractive alternative to surgery.

Adult↗
PubMed1994

[Who counsels young people on contraception?].

In October 1989 a representative sample consisting of 359 women (response rate = 77.9%) and 400 women (response rate = 76.3%) aged 16-20-years old was interviewed by the professional interviewer staff of the Institute for Social Research. The purpose of the investigation was to illustrate whether AIDS and "Safe sex"-campaigns have influenced young people. This paper deals with data about contraceptive counselling. The majority (284 (79.1%) among women and 270 (67.5%) among men) would attend the general practitioner for contraceptive guidance. The public Contraceptive Guidance Clinics are considered an alternative source of service. In all, 38.2% of females and 29.3% of males knew of the existence of a clinic. This knowledge was not associated with age or education of the respondent. Among men information about the clinic was associated with sexual experience. Schools appear to be an effective channel of information. In the county of Ribe more than 80% among both sexes knew th public clinic.

Adolescent↗