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Biomedical subjects

D A Koutras

Publications and source records attributed to D A Koutras.

At least 19 recordsLinked to original sources
PubMed1992

The effect of iodide on serum thyroid hormone levels in normal persons, in hyperthyroid patients, and in hypothyroid patients on thyroxine replacement.

OBJECTIVE: To clarify the duration and the extent of the antithyroid effect of iodides in hyperthyroidism, and to investigate whether iodides have an additional peripheral effect on the metabolism of thyroid hormones, as has been reported for some organic iodine compounds. DESIGN: The effect on the peripheral thyroid hormone levels of 150 mg of potassium iodide daily (equivalent to 114 mg of iodide) for 3-7 weeks was compared in 21 hyperthyroid patients and 12 healthy controls. A possible effect of iodide on the peripheral metabolism of thyroid hormones was investigated by assessing the serum levels of thyroid hormone in 12 hypothyroid patients on thyroxine replacement for 2 weeks. PATIENTS: There were 21 thyrotoxic patients, 12 healthy hospital controls, and 12 patients with complete or near-complete hypothyroidism, on thyroxine replacement. MEASUREMENTS: The following were measured before and at weekly intervals after iodide administration: (1) pulse rate, (2) serum T4, (3) serum T3, (4) serum TSH, (5) serum thyroxine-binding capacity (TBC), (6) serum rT3, (7) serum thyroxine-binding globulin (TBG), (8) the free-T4 Index, calculated as T4/TBC. RESULTS: In the hyperthyroid patients serum T4, T3 and rT3 decreased, whereas serum thyroxine-binding globulin and thyroxine binding capacity increased. Serum T3, however, did not become completely normal in all cases. After 21 days, serum T4 and T3 started increasing again in some cases, but other patients remained euthyroid even after 6 weeks. In the normal controls there was a small but significant and consistent decrease in serum T4, T3 and rT3 and an increase in serum TSH. Finally, in the T4-treated hypothyroid patients there was no consistent change, except for an increase of serum T4 at 1 and 14 days and a decrease of serum TSH the first day. CONCLUSION: Iodides in hyperthyroidism have a variable and unpredictable intensity and duration of antithyroid effect. Their antithyroid effect is smaller in normal controls. They have no important effect on the peripheral metabolism of thyroid hormones.

Adult↗
PubMed1991

Increased mean serum thyrotropin in apparently euthyroid hypercholesterolemic patients: does it mean occult hypothyroidism?

Serum thyroid hormones and antithyroid autoantibodies (AAB) were assayed in 87 randomly selected hypercholesterolemic persons compared to 80 controls with normal serum total cholesterol (TC). Of the 87 hypercholesterolemic persons 22 (25%) had positive AAB compared to 5 (6%) controls. Furthermore, 8 of the hypercholesterolemic patients had a serum TSH level above 5 mU/l, i.e. the had subclinical hypothyroidism, not diagnosed before, whereas thyroid function was normal in all normocholesterolemic persons. The new and unexpected finding was that the hypercholesterolemic persons had on average a significantly higher serum TSH than the controls, and this was true even when persons with positive AAB were excluded. There was a significant correlation between TC and serum TSH. It is concluded that hypothyroidism may not be an all-or-none phenomenon, and that many hypercholesterolemic persons with thyroid tests within the conventional normal range may have a slight impairment of their thyroid function.

Female↗
PubMed1991

Treatment of hyperthyroidism with potassium iodide.

Potassium iodide was given to 17 cases of Basedow's disease in comparison to 12 normal controls for 5 weeks. In the thyrotoxic patients, the maximum decrease in serum T3 and T4 levels was observed 2 and 3 weeks, respectively, but in some cases remained normal even at 5 weeks. The euthyroid persons showed a small decrease in T4 and T3 and an increase in serum TSH.

Adult↗
PubMed1991

The outcome of benign thyroid nodules correlates with the findings of fine needle biopsy.

204 patients with a single or dominant 'cold' thyroid nodule were treated with l-thyroxine, 150-250 micrograms/d, for 4 to 12 months. The two clinicians who evaluated the evolution of the nodules knew that fine-needle biopsy (FNB) had excluded malignancy, but ignored any other morphologic data of the FNB smears. Good outcome, i.e. disappearance of the nodule or definite decrease in its size, was observed in 66 cases (32%). This good clinical outcome was correlated with various morphologic characteristics of the FNB aspirate. The nodule was more likely to regress if FNB showed much colloid, many degenerative changes and many phagocytes, whereas the presence of extensive hyperplasia, lymphocytes or fibrosis were associated with an unfavourable prognosis. With logistic regression, controlling for the confounding effects of sex, age, clinical and histological picture and thyroxine dose, significant correlations were shown with the presence of colloid, hyperplasia and fibrosis. It is concluded that the morphologic characteristics of the FNB aspirate may, to some extent, predict the outcome of cold thyroid nodules.

Adult↗
PubMed1990

Clinical, laboratory and immunologic effects of the treatment of endemic goiter with T4, T3 and KI.

We treated 204 patients with endemic nontoxic goiter with T4, T3 and KI, singly or in combination. Definitely nodular goiters were excluded, since the possibility of autonomy would be increased. Goiter size was evaluated before and 6 months after treatment clinically in a blind way, i.e. the observer (always the same) did not know either the pretreatment goiter size or the treatment the patient had received. At the same time various laboratory parameters were recorded. All the active treatments (but not placebo) resulted in a highly significant decrease in the gland size. The effectiveness decreased in the following order: 1) T3 50 micrograms/d (most effective), 2) (T4 50 micrograms/d + T3 12.5 micrograms) x 2, 3) T4 150 micrograms + iodide 150 micrograms/d, 4) T4 75 micrograms + T3 18.75 micrograms/d, 5) T4 200 micrograms/d, 6) T3 37.5 micrograms/d, 7) Iodide 300 micrograms/d, 8) T4 150 micrograms/d, 9) Iodide 150 micrograms/d (least effective) and 10) Placebo (not effective). The results show that T4 200 micrograms and T3 50 micrograms are roughly equipotent, and slightly more effective than 300 micrograms of Iodide. Taking into consideration the side effects (increase in pulse rate, shortening of the Achilles tendon reflex) did not change the order of effectiveness in an important way. The clinical outcome correlated in general with the suppression of the 131I uptake (r = 0.220, p = 0.03) and the TRH test (r = 0.248, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗
PubMed1979

The radiological assessment of body fat.

A radiological method for assessment of obesity is described. A radiograph of the soft tissues of the upper arm is obtained and the subcutaneous fat layer measured. The results obtained by this method have been compared with those using a skinfold caliper and with the ponderal index, calculated from the height and weight of the subject. A highly significant correlation was found. The radiological method has several advantages: it leaves a permanent record, it is accurate in obese persons when the skinfold caliper cannot be used, and unlike the ponderal index it is not influenced by weight increases due to causes other than fat accumulation.

Adipose Tissue↗
PubMed1978

Free-thyroxine index in psychotic and neurotic depression.

The mean free-thyroxine index value of a group of 25 psychotic depressive patients was found to be significantly lower than that of an age- and sex-matched group of 20 neurotic depressives (P less than 0.01). These findings support the view that psychotic and neurotic depression are differentiated not only with respect to their clinical expression, but also on account of their biological substrate. Comparison of free-thyroxine index values of each group of patients with a group of 240 euthyroid subjects hospitalized for various somatic illnesses revealed a lower mean free-thyroxine index value in the group of psychotic depressives (P less than 0.001). The neurotic depressives were not differentiated from the group of euthyroid subjects. The decreased thyroid activity in psychotic depression might be interpreted in the light of recent findings implicating catecholamines in both the release of hypothalamic hormones and the neurochemical mechanism of the affective disorders.

Adjustment Disorders↗
PubMed1978

Lack of influence of povidone-iodine on tests of thyroid function.

The external application of povidone-iodine, an antiseptic agent, was tested for its influence on thyroid function. Previous workers have described some in vitro changes in thyroid function tests following its use. In the present study topical application of povidone-iodine did not affect thyroid function as measured some days later using both in vivo and radio-active iodine in vitro test methods, despite the fact that the latter are notorious for being influenced by exogenous iodine.

Administration, Topical↗
PubMed1978

Iodide organification defect in iodine deficiency endemic goiter.

In 17 goitrous persons in an iodine-deficient area, in 23 nongoitrous inhabitants of the same village, in 10 goitrous persons in Athens, and 8 normal controls the perchlorate discharge test was performed, either in the simple standard form or after pretreatment with either 0.5 or 2.0 mg potassium iodide or 2.5 mg carbimazole. With the simple test or with 0.5 mg potassium iodide, there was no significant discharge in any group studied. With 2.5 mg carbimazole, there was a profound discharge of the trapped iodide in both groups in the iodine-deficient area. With 2.0 mg potassium iodide, however, there was a clear discharge in the two goitrous groups (i.e. the one in the endemic area and the second in Athens), a less pronounced discharge in the controls studied in Athens, and no discharge at all in the nongoitrous inhabitants of the iodine-deficient endemic area. These findings provide evidence for an abnormality present in the patients with endemic goiter, most probably faulty iodine utilization due to impaired organic binding. The nongoitrous persons in the endemic areas, on the other hand, seem to be even more efficient in handling the trapped iodide than the controls studied in Athens. These findings may provide an explanation for previous observations that in endemic areas only part of the population develop a goiter, whereas the others adapt successfully to iodine deficiency without significantly enlarging their glands.

Child↗
PubMed1977

The toxic effect of small iodine supplements in patients with autonomous thyroid nodules.

In sixteen cases of toxic adenoma of the thyroid (autonomous hot nodule with complete suppression of the surrounding normal parenchyma) potassium iodide was given in doses of 100 microgram/day for one week, 200 microgram/day for another and 400 microgram/day for a third week. There was a progressive increase in the serum T4 level. Serum T3 also increased, although this was significant only after the first week. Serum TSH was undetectable throughout the entire period of the study. This metabolic pattern is different from the response seen in cases of nontoxic endemic goitre, where small iodine supplements induce an increase in serum T4 but a decrease in serum T3. Furthermore, the present results may explain the phenomenon of iodine-induced or iodine-precipitated hyperthyroidism (Jod-Basedow) when patients with autonomous thyroid are presented with a high iodine intake. In contrast to the results obtained with small iodide doses, two other cases treated with large pharmacological doses of iodide showed a decrease in both serum T4 and serum T3. It is concluded that the physician should be aware of the possibility of precipitating or aggravating thyrotoxicosis in patients with an autonomous hot nodule by increasing their intake of iodine.

Goiter, Nodular↗
PubMed1977

Carcinoembryonic antigen in thyroid disease.

Plasma carcinoembryonic antigen (CEA) levels were measured by the Z-Gel technique in 138 patients with benign thyroidopathies, 25 patients with thyroid cancer, and 141 normal persons. Levels were raised (above 5 ng/ml) in 2% of the normal subjects, in none of the patients with benign thyroidopathies, and in 20% of the patients with thyroid cancer. They were considerably raised in all cases of medullary carcinoma of the thyroid but they were also high in other histological types of thyroid cancer. Measurement of plasma CEA may be of value in the preoperative diagnosis and follow-up of patients with thyroid cancer.

Carcinoembryonic Antigen↗