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Biomedical subjects

G Sundbeck

Publications and source records attributed to G Sundbeck.

10 recordsLinked to original sources
PubMed2000

Booster effect of low doses of tetanus toxoid in elderly vaccinees.

In order to improve the immunity to diphtheria, the recommended booster dose of diphtheria/tetanus vaccine for adults in Sweden was changed in 1986 from 0.5 ml of tetanus vaccine with a small diphtheria dose to 0.25 ml of a diphtheria/tetanus vaccine containing 7.5 Lf tetanus toxoid and 30 Lf diphtheria toxoid/ml. This change resulted in an increase in the dose of diphtheria toxoid from 0.5 Lf to 7.5 Lf, but a decrease in the recommended booster dose of tetanus toxoid from 3.75 Lf to 1.9 Lf. The aim of the present study was to investigate whether this lower dose of tetanus toxoid was also sufficiently protective for elderly people. Two hundred adults (median age 76 years, range 60-92 years) with no history of tetanus vaccination during the past 10 years volunteered for the study. One hundred two vaccinees were inoculated with 1.9 Lf tetanus toxoid (0.25 ml) and 98 with 3.75 Lf tetanus toxoid (0.5 ml). Paired serum samples were analysed by the toxin-binding inhibition assay. Side effects were few and mild, without significant differences between the groups. Response rates were similar, with the 3.75 Lf dose eliciting a marginally higher antitoxin response. The prevaccination geometric mean titre was the same for both groups: 0.03 IU/ml. Postvaccination geometric mean titres were 1.18 IU/ml for the 3.75 Lf group and 1.93 IU/ml for the 7.5 Lf group, respectively (difference not significant). Forty-seven percent of the vaccinees had a prevaccination titre of < or =0.01 IU/ml. Postvaccination, 85% had a titre >0.01 IU/ml. Booster vaccination with tetanus vaccine containing only 1.9 Lf of tetanus toxoid was thus found to induce an excellent immune response in elderly people, with few side effects resulting.

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PubMed1995

Prevalence of serum antithyroid peroxidase antibodies in 85-year-old women and men.

Antithyroid peroxidase antibodies (TPOAb) were determined by competitive radioassay in serum samples obtained from a representative population of 85-year-olds (601 women and 285 men). The prevalence of increased TPOAb concentration was significantly higher in the women. In individuals without previously known thyroid dysfunction, 16% of the women and 9% of the men had TPOAb concentration > 100 kilo-units/L, the upper decision limit. We found a direct relationship between TPOAb and thyrotropin (TSH) concentrations and an inverse relationship between TPOAb and free thyroxine (T4) concentrations, but no relationship between TPOAb and defined disorders or treatment with pharmaceutical drugs. Exclusion of individuals with increased TPOAb concentration and conditions influencing TSH and free T4 concentrations resulted in a decrease of the upper reference limit for TSH concentration and an increase of the lower limit for free T4 concentration, indicating that high TPOAb concentration should be taken into account when evaluating normal reference intervals for thyroid-function tests in the elderly.

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PubMed1991

Screening for thyroid disease in the elderly. Serum free thyroxine and thyrotropin concentrations in a representative population of 81-year-old women and men.

Thyroid function in individuals from a representative population of 81-year olds was evaluated clinically and from assay of serum thyrotropin (TSH) and serum free thyroxine (free T4). Among the 144 men, 2 had markedly abnormal values; L-thyroxine treatment had been prescribed for both, one because of primary hypothyroidism (concentrations at screening were high for TSH and low for free T4) and one because of panhypopituitarism (low free T4 at screening). Among the 250 women, 10 had TSH concentrations greater than 10 mU/L; L-thyroxine therapy had been prescribed for 3 of them. Only 1 non-L-thyroxine treated woman had a high free T4 concentration. She had few clinical signs and symptoms of hyperthyroidism (mainly weight loss), and multinodular goiter. Total and free 3,5,3'-triiodothyronine concentrations were normal but her total and free T4 concentrations were high at ages 70, 75 and 79 years, indicating that "T4-toxicosis" had been present for at least 11 years without evidence of progression of her hyperthyroidism. The results indicate that clinical signs and symptoms of thyroid disease in the elderly may be too subtle for diagnosis.

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PubMed1991

Incidence and prevalence of thyroid disease in elderly women: results from the longitudinal population study of elderly people in Gothenburg, Sweden.

The incidence and prevalence of thyroid dysfunction were estimated in a longitudinal study of a representative sample of elderly women at ages 70, 75, 79 and 81. Thyroid-stimulating-hormone concentrations were measured in frozen samples obtained at the ages of 70 and 75 that had been stored for ten and five years, respectively. At the ages of 79 and 81 the serum concentrations of thyroid-stimulating hormone were determined in connection with the sampling. For comparison, thyroid-stimulating-hormone concentrations were also measured in another representative population sample of women at ages 70 (n = 297) and 76 (n = 342), in whom measurements were carried out in direct connection to the clinical study. History of previous thyroid disease, e.g. thyroid surgery and thyroid hormone treatment, was obtained through a questionnaire. Information about previous treatment with radio-iodine was obtained from records. At the age of 70, 1.9% had had thyroid surgery but none had been treated with radio-iodine. L-Thyroxine had been prescribed for 3.5%, and another 3.9% had high thyroid-stimulating-hormone concentrations (greater than 10.0 mU/l) indicating thyroid hypofunction. Between 70 and 79 years of age, eight of the 514 women had developed high concentrations of thyroid-stimulating hormone and another two women had received treatment with L-thyroxine. Three women had received radio-iodine therapy. In addition, one woman at the age of 81 was discovered to have hyperthyroidism. The retrospective analysis showed that markedly elevated TSH concentrations had been present in several women for at least nine years.(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed1991

Thyroid dysfunction in 85-year-old men and women. Influence of non-thyroidal illness and drug treatment.

Serum TSH and free T4 were determined by chemiluminometric assays in 601 women and 285 men aged 85 years from the population study "70-year-old people in Gothenburg, Sweden". For individuals with serum TSH concentration above 6.0 mU/l, "antimicrosomal" antibodies were determined, to assess the etiology of the elevated TSH concentration. Clinical follow-up was done of survivors until the age of 88, and records were inspected also for individuals who died before that age. On the basis of these evaluations the prevalence of previously undetected hypothyroidism was estimated to 4.0% in women and 2.5% in men. Previously undetected hyperthyroidism was found in 2, at the most 4, out of 601 women; in one out of 285 men the diagnosis could not be excluded. Possible confounding factors for the evaluation of TSH and/or free T4 concentrations were analysed by permutation t-test followed by multiple regression analysis, which revealed correlations of log TSH concentration to body mass index (p less than 0.05), serum creatinine concentration (p less than 0.05), and diabetes mellitus (inverse relationship, p less than 0.01). Correlation was found of free T4 concentration to treatment with non-selective beta-blocking agents (p less than 0.001) and digitalis glycosides (p less than 0.01). However, none of the factors influencing TSH and/or free T4 concentrations had any major influence on reference limits, nor could they account for individuals with "out-lier" values.

Adrenergic beta-Antagonists↗
PubMed1991

Clinical significance of low serum thyrotropin concentration by chemiluminometric assay in 85-year-old women and men.

The prevalence and causes of low serum thyrotropin concentration were studied in 886 individuals at age 85 years (601 women and 285 men). All participants were subject to detailed clinical and biochemical evaluation, including determination of serum thyrotropin and free thyroxine concentrations by chemiluminometric assays. Samples with thyrotropin concentrations below 0.20 mU/L or above 6.0 mU/L and/or free thryoxine concentrations above 22.0 pmol/L were selected for further assays. These selected individuals were followed-up during 3 years. Of 18 individuals without thyroid hormone treatment who had thyrotropin concentrations less than 0.20 pmol/L (13 below 0.10 pmol/L), only two were proved to be hyperthyroid; in another three, hyperthyroidism could not be excluded. The results indicate that most elderly individuals with low serum thyrotropin concentrations are not hyperthyroid and that abnormal thyroxine-binding globulin (in conjunction with drug treatment or nonthyroidal illness) is not a common cause of low thyrotropin concentration.

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PubMed1988

Screening for thyroid disease in the elderly. Serum concentrations of thyrotropin and 3,5,3'-triiodothyronine in a representative population of 79-year-old women and men.

Thyroid function in individuals from a representative population of 79-year-olds was evaluated clinically and from measurements of serum thyrotropin (TSH) and 3,5,3'-triiodothyronine (T3). High TSH concentrations (greater than or equal to 10 mU/l) were found in 16 of 320 women (5%) and 2 of 204 men (1%). Signs and symptoms which traditionally are regarded as related to hypothyroidism were as common in subjects with high TSH concentration as in the remaining population and occurred in 10-50% of the subjects. In the 16 women with high TSH, free thyroxine (free T4) concentrations were low in 10, whereas only one subject had low thyroxine (T4) and T3 concentrations, indicating that free T4 is a more sensitive parameter for thyroid hypofunction in the elderly. Based on the T3 assay, there was no evidence for hyperthyroidism in this population. The results indicate that high TSH concentrations are common in elderly women, less common in men. The results show that classical symptoms of thyroid dysfunction are quite common in 79-year-olds, but do not correlate with biochemical indicators of thyroid dysfunction, indicating that defining "clinically euthyroid" in an elderly may be almost impossible.

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