Biomedical subjects

C Als

Publications and source records attributed to C Als.

24 records · Page 2Linked to original sources

PubMed1995

[Toxic adenomas of the thyroid gland becoming less frequent in Berne].

The frequency distribution of immunogenic and non-immunogenic hyperthyroidism (IH, NIH) was evaluated retrospectively in the former endemic goiter area of Berne over a 15-year period (1976, 1982, and 1991). Out of 12,320 patients referred for thyroid examinations, 9.1% were hyperthyroid. NIH still predominates with a constant frequency of 59%; but the ratio between toxic adenomas (TA) and multifocal functional autonomies (MFA) was significantly inversed, from 2.6 over 0.9 to 0.4. The frequency of TA decreased from 41% to 17% and that of MFA increased from 16% to 38%. The arithmetic mean age at diagnosis was constant: 53.9 (IH), 61.5 (TA) and 67.5 years (MFA). The decreasing frequency of TA over the last 15 years is explained by an increased but still insufficient iodine supply.

Aged↗

PubMed1995

The instability of dietary iodine supply over time in an affluent society.

In the Bernese region, where goiter was formerly endemic, alimentary salt has been supplemented by increasing amounts of potassium iodide (KI): 5, 10, 20 mg KI/kg in 1922, 1965 and 1980 respectively. Ioduria rose from < 30 micrograms I/g creatinine in 1920 to > 100 micrograms I/g creatinine in the 1980s. In 1992 ioduria was estimated in 55 healthy volunteers (group A and individual B) and 234 thyroid carcinoma patients after thyroidectomy: hypothyroid patients with (C) and without thyroid remnants (D) and euthyroid patients on T4 substitution (E). The arithmetic mean iodine excretion of the healthy volunteers in group A and individual B was found to be 87 +/- 40 micrograms I/g creatinine. This is insufficient according to the recommendations of the WHO. In all groups, the iodine excretion reached the recommended level only in some members: 24% (A, B), 19% (C), 38% (D) and 81% (E). It was thought in the 1980s that in a formerly iodine-deficient society, iodinated salt would continue to provide an adequate supply of iodine. However, iodine intake in this affluent society has proved to be unstable. This can be attributed to modifications of eating habits, which include a reduction of total salt consumption, combined with a growing consumption of manufactured food of cosmopolitan origin, prepared using salt containing little or no iodine.

Adolescent↗

PubMed1995

Immunogenic and non-immunogenic hyperthyroidism. Recent trends in prealpine Switzerland and in coastal Poland.

Annual occurrences of immunogenic (IH) and non-immunogenic hyperthyroidism (NIH) between Berne (1976, 1982, 1991) and Szczecin (1973, 1980, 1991) were compared. Out of 21,025 patients referred for thyroid examinations, 10.1% (average) were hyperthyroid. In Berne (former endemic goiter region) and Szczecin (without goiter endemicity) IH occurred in 41% and 68%, NIH in 59% and 32% of hyperthyroid patients, respectively. Within a stable incidence of NIH in Berne, toxic adenomas (TA) decreased from 41% (1976) to 17% (1991) (p < 0.005). In Szczecin, where iodine deficiency is in an early stage, the TA frequency did not change significantly: from 24% (1973) to 28% (1991). Increases of TA or of multifocal functional autonomy apparently "mark" incipient or, respectively, decreasing deficiencies in nutritious iodine. Hyperthyroid patients in Berne compared to Szczecin were older, both with IH (54 versus 45 y) and NIH (65 versus 52 y). Age at diagnosis was stable in Berne but increasing (p < 0.05) in Szczecin (from 43 to 52 y).

Adenoma↗

PubMed1995

Separation of autonomous function from cell density in non-immunogenic hyperthyroidism. I. Quantification by double-isotope parametric scintigraphy.

UNLABELLED: A new quantitative subtraction method of thyroid scans is proposed which shows that regional function (F) by far exceeds regional cellularity or cell density (C) in potentially toxic thyroidal areas of non-immunogenic hyperthyroidism (NIH). METHODS: A multistep processing of radioiodine and MIBI thyroid scans of patients with non-immunogenic hyperthyroidism led to normalized images of regional function excess and of perinodular enhancement. Two numeric factors were derived from regions of interest: Q (cell density ratio) comparing MIBI uptake in autonomous and suppressed areas and T (toxicity index): the maximal F/C contrast. RESULTS: Q never exceeded 61; T, however, expanded toxicity levels over a range of 6-8735 with toxic adenomas (median = 165) and with hot areas of multifocal functional autonomy (median = 15). T was weakly correlated to serum TT3 (r = 0.41), but not to autonomous tissue mass, ultrasonographic or cytologic criteria. CONCLUSIONS: T is governed by inherent features of autonomous tissue and the response of the imbedded thyroid tissue to TSH stimulation. This standardized technique consolidates experiences from visual analysis; the huge T range mirrors the natural evolution from compensated autonomy towards hyperthyroid, decompensated stages.

Diagnosis, Differential↗

PubMed1993

Influence of patient's weight on dual-photon absorptiometry and dual-energy X-ray absorptiometry measurements of bone mineral density.

Lumbar spine bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) (Hologic QDR 1000) and by 153Gd dual-photon absorptiometry (DPA) (Novo Lab 22a) in 120 postmenopausal women. Though a high correlation existed between the two techniques, the ratio between DXA and DPA values was not constant. Using DXA we observed a higher dependence of BMD on weight than in the DPA measurements. To investigate the different behaviour of DXA and DPA machines with weight, we analysed the effects of increasing thickness of soft tissue equivalents on the BMD of the Hologic spine phantom and on the BMD equivalent of an aluminium standard tube. Increasing tissue-equivalent thickness caused the phantom BMD measured by DPA to decrease significantly but had not effect on the DXA measurements. The different behaviour of DPA and DXA equipment with regard to the phantoms could account for the differences observed in the relations between BMD and weight in the patients. Using multiple regression we studied the influence of weight and body mass index on the relation between BMD measured by the two techniques. The introduction of either of these variables into the regression resulted in an improvement of the prediction of the DXA values from the DPA values. However, the residual standard error of the estimate was still higher than the combined precision errors of the two methods, so that no simple relation allows a conversion of BMDDPA into BMDDXA. Our results confirm that BMD is positively correlated with weight in postmenopausal women; the influence of weight on BMD is blunted when the Novo Lab 22a DPA machine is used for measuring bone mineral.

Absorptiometry, Photon↗

PubMed1989

[Natural history and classification of HIV-virus infections].

Clinical concepts about the acquired immunodeficiency syndrome, are evolving constantly. Laboratory tests are used to prove the infection virologically and serologically, to quantify the importance of immunodeficiency and to give a tentative prognosis. We discuss three classification systems (CDC, Haverkos, Walter Reed). They are more or less precise and suitable. They may indicate the status of the disease, from seroconversion up to opportunistic infections and secondary cancers. Then we compare those different systems of classification, their advantages and disadvantages. These classification systems may change with evolving concepts about the syndrome.

AIDS-Related Complex↗