Triiodothyronine and thyroxine treatment of diffuse non-toxic goitre evaluated by ultrasonic scanning

1982 ◽  
Vol 100 (3) ◽  
pp. 382-387 ◽  
Author(s):  
H. Perrild ◽  
J. M. Hansen ◽  
L. Hegedüs ◽  
L. Rytter ◽  
B. Holm ◽  
...  

Abstract. Ultrasonic scanning has been used to estimate changes in goitre size during and after treatment with a daily dose of either 100 μg thyroxine (T4) (n = 30), 150 μg T4 (n = 33), 200 μg T4 (n = 17) or 60 μg triiodothyronine (T3) (n = 30) for one year in patients with diffuse non-toxic goitre. The thyroid volume was measured before and every 3 months during and 3 months after withdrawal of therapy. All 4 treatments resulted in a decrease in goitre size after 3 months' therapy (P < 0.05) but only in the patients given 200 μg T4 and 60 μg T3 was the decrease long lasting during additional 9 months' therapy. The mean reduction in thyroid volume after 12 months therapy was 30 ± 26 sd and 22 ± 30 (sd)%, respectively. The free-T4-index was found significantly raised throughout the treatment with all three T4 doses, whereas the free-T3-index did not change. During treatment with 60 μg T3 no persistent rise in free-T3-index was seen while free-T4-index was decreased all 12 months. No increase in goitre size was observed 3 months after withdrawal of the T3 therapy (n = 15), whereas all goitres in the T4 treated groups had returned to the pre-treatment values at that time. No rebound phenomenon was observed. The serum T3 and T4 levels were normalized 3 months after withdrawal in all four groups. Seven out of 8 patients on 200 μg T4 daily and 20 out of 25 patients on 60 μg T3 daily had no TSH response to TRH (200 μg iv) after 3 months' therapy. Forty-three out of 61 patients in the 4 groups showed no TSH response to TRH after 3 months' therapy. Only the group of patients showing no TSH response to TRH after 3 months' treatment had a significant decrease in goitre size in contrast to the group with a positive response to TRH.

Rangifer ◽  
2002 ◽  
Vol 22 (2) ◽  
pp. 115 ◽  
Author(s):  
Arne C. Nilssen ◽  
Willy Hemmingsen ◽  
Rolf E. Haugerud

The highly efficient endectocide ivermectin is used to reduce the burden of parasites in many semidomestic reindeer herds in northern Fennoscandia. In the autumn of 1995 and 1996 all reindeer on the island of Silda (42 km2) were treated with ivermectin in an attempt to eradicate the warble fly (Hypoderma (=Oedemagena) tarandi (L.)), the nose bot fly (Cephenemyia trompe (Modeer)) (Diptera: Oestridae) and the sinus worm (Linguatula arctica Riley, Haugerud and Nilssen) (Pentastomida: Linguatulidae). Silda is situated 2-3 km off the mainland of Finnmark, northern Norway, and supports about 475 reindeer in summer. A year after the first treatment, the mean abundance of H. tarandi was reduced from 3.5 to 0.6, but a year after the second treatment the mean abundance unexpectedly had increased to 4.5. After one year without treatment, the mean abundance and prevalence of the three target parasites were at the same level, or higher, than pre-treatment levels. The main hypothesis for the failure to eliminate the parasites is that gravid H. tarandi and C. trompe females originating from untreated reindeer in adjacent mainland areas dispersed to the island during the warm summer of 1997 (possibly also in 1998). As these oestrids are strong flyers, it may not be too difficult for them to cross &gt;2-3 km of oceanic waters. There are no good explanations for the failure to eradicate L. arctica, but the results indicate that there may be elements in its life cycle that are unknown. The conclusion of the study is that it may be difficult or impossible to eradicate these parasites permanently, even locally such as on islands unless adjacent areas on the mainland are also cleared.


1993 ◽  
Vol 69 (04) ◽  
pp. 321-327 ◽  
Author(s):  
E Seifried ◽  
M Oethinger ◽  
P Tanswell ◽  
E Hoegee-de Nobel ◽  
W Nieuwenhuizen

SummaryIn 12 patients treated with 100 mg rt-PA/3 h for acute myocardial infarction (AMI), serial fibrinogen levels were measured with the Clauss clotting rate assay (“functional fibrinogen”) and with a new enzyme immunoassay for immunologically intact fibrinogen (“intact fibrinogen”). Levels of functional and “intact fibrinogen” were strikingly different: functional levels were higher at baseline; showed a more pronounced breakdown during rt-PA therapy; and a rebound phenomenon which was not seen for “intact fibrinogen”. The ratio of functional to “intact fibrinogen” was calculated for each individual patient and each time point. The mean ratio (n = 12) was 1.6 at baseline, 1.0 at 90 min, and increased markedly between 8 and 24 h to a maximum of 2.1 (p <0.01), indicating that functionality of circulating fibrinogen changes during AMI and subsequent thrombolytic therapy. The increased ratio of functional to “intact fibrinogen” seems to reflect a more functional fibrinogen at baseline and following rt-PA infusion. This is in keeping with data that the relative amount of fast clotting “intact HMW fibrinogen” of total fibrinogen is increased in initial phase of AMI. The data suggest that about 20% of HMW fibrinogen are converted to partly degraded fibrinogen during rt-PA infusion. The rebound phenomenon exhibited by functional fibrinogen may result from newly synthesized fibrinogen with a high proportion of HMW fibrinogen with its known higher degree of phosphorylation. Fibrinogen- and fibrin degradation products were within normal range at baseline. Upon infusion of the thrombolytic agent, maximum median levels of 5.88 μg/ml and 5.28 μg/ml, respectively, were measured at 90 min. Maximum plasma fibrinogen degradation products represented only 4% of lost “intact fibrinogen”, but they correlatedstrongly and linearly with the extent of “intact fibrinogen” degradation (r = 0.82, p <0.01). In contrast, no correlation was seen between breakdown of “intact fibrinogen” and corresponding levels of fibrin degradation products. We conclude from our data that the ratio of functional to immunologically “intact fibrinogen” may serve as an important index for functionality of fibrinogen and select patients at high risk for early reocclusion. Only a small proportion of degraded functional and “intact fibrinogen”, respectively, is recovered as fibrinogen degradation products. There seems to be a strong correlation between the degree of elevation of fibrinogen degradation products and the intensity of the systemic lytic state, i.e. fibrinogen degradation.


1986 ◽  
Vol 113 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Laszlo Hegedüs ◽  
Dagmar Veiergang ◽  
Steen Karstrup ◽  
Jens Mølholm Hansen

Abstract. Thyroid function and thyroid gland volume, ultrasonically determined, were investigated in 27 hyperthyroid patients with solitary autonomous thyroid nodules before and during one year after 131I-treatment. Total thyroid volume decreased gradually from 40.9 ± 3.5 ml (mean ± sem) before treatment to 23.9 ± 1.8 ml (P < 0.001) at 3 months after 131I-treatment. No further change was observed. All but two patients received only one dose of 131I, and in spite of a significant decrease also of the non-adenoma side of the gland, none became hypothyroid. We conclude that 131I-therapy has an important place in the treatment of solitary autonomous thyroid nodules since all our patients became euthyroid within 3 months, only 2 of 27 patients needed more than one dose of 131I, no cases of hypothyroidism occurred, and thyroid volume was substantially decreased.


2014 ◽  
Vol 9 (4) ◽  
pp. 30-35
Author(s):  
S Datta ◽  
S Maiti ◽  
G Das ◽  
A Chatterjee ◽  
P Ghosh

Background The diagnosis of classical Kawasaki Disease was based on clinical criteria. The conventional criteria is particularly useful in preventing over diagnosis, but at the same time it may result in failure to recognize the incomplete form of Kawasaki Disease. Objective To suspect incomplete Kawasaki Disease, because early diagnosis and proper treatment may reduce substantial risk of developing coronary artery abnormality which is one of the leading causes of acquired heart disease in children. Method Nine cases of incomplete Kawasaki Disease were diagnosed over a period of one year. The diagnosis of incomplete Kawasaki Disease was based on fever for five days with less than four classical clinical features and cardiac abnormality detected by 2D- echocardiography. A repeat echocardiography was done after 6 weeks of onset of illness. The patients were treated with Intravenous Immunoglobulin and/or aspirin. Result The mean age of the patients was 3.83 years and the mean duration of symptoms before diagnosis was 12.1 days. Apart from other criteria all of our patients had edema and extreme irritability. All the patients had abnormal echocardiographic finding. Five patients received only aspirin due to nonaffordability of Intravenous Immunoglobulin and four patients received both aspirin and Intravenous Immunoglobulin, but the outcome was excellent in all the cases. Conclusion Incomplete Kawasaki Disease can be diagnosed with more awareness and aspirin alone may be used as a second line therapy in case of non affordability of Intravenous Immunoglobulin. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 30-35 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10234


2021 ◽  
Vol 10 (1) ◽  
pp. 152
Author(s):  
Athanasios D. Anastasilakis ◽  
Polyzois Makras ◽  
Maria P. Yavropoulou ◽  
Gaia Tabacco ◽  
Anda Mihaela Naciu ◽  
...  

Denosumab is a potent antiresorptive agent that substantially increases bone mineral density and reduces fracture rates at all skeletal sites for as long as it is administered. However, its favorable skeletal effects reverse quickly upon its discontinuation, because of a vast increase of osteoclast number and activity, which leads to a subsequent profound increase of bone turnover above pre-treatment values, a phenomenon commonly described as “rebound phenomenon”. More importantly, most patients experience rapid, profound bone loss due to this burst of bone resorption that may lead in a minority of these patients to occurrence of fractures, especially multiple vertebral fractures. Therefore, subsequent antiresorptive treatment is mandatory, although the optimal regimen is yet to be clarified. In the present review, we outline what is currently known regarding the negative effects of denosumab discontinuation on different aspects of bone status, the factors that may affect them, and strategies to prevent them.


Symmetry ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 457
Author(s):  
Isabel María Introzzi ◽  
María Marta Richard’s ◽  
Yesica Aydmune ◽  
Eliana Vanesa Zamora ◽  
Florencia Stelzer ◽  
...  

Recent studies suggest that the developmental curves in adolescence, related to the development of executive functions, could be fitted to a non-linear trajectory of development with progressions and retrogressions. Therefore, the present study proposes to analyze the pattern of development in Perceptual Inhibition (PI), considering all stages of adolescence (early, middle, and late) in intervals of one year. To this aim, we worked with a sample of 275 participants between 10 and 25 years, who performed a joint visual and search task (to measure PI). We have fitted ex-Gaussian functions to the probability distributions of the mean response time across the sample and performed a covariance analysis (ANCOVA). The results showed that the 10- to 13-year-old groups performed similarly in the task and differ from the 14- to 19-year-old participants. We found significant differences between the older group and all the rest of the groups. We discuss the important changes that can be observed in relation to the nonlinear trajectory of development that would show the PI during adolescence.


2021 ◽  
pp. 1-25
Author(s):  
Lanchun Liu ◽  
Lixiang Liu ◽  
Ming Li ◽  
Yang Du ◽  
Peng Liu ◽  
...  

Abstract The policy of Universal Salt Iodization (USI) could reduce population’s thyroid volume (TVOL) in iodine deficiency areas. Conversely, the improved growth and developmental status of children might increase the TVOL accordingly. Whether the decreased TVOL by USI conceals the increase effect of height and weight on TVOL is unclear. The aim of this study was to analyse the association between height, weight, iodine supplementation and TVOL. Five national Iodine Deficiency Disorder surveys were matched into four pairs according to the purpose of analysis. County-level data of both detected by paired surveys were incorporated, 1: 1 random pairing method was used to match counties or individuals. The difference of TVOL between different height, weight, different iodine supplementation measures groups and the association between TVOL and them were studied. The mean height and weight of children aged 8-10 years increased from 129.9cm and 26.9kg in 2002 to 136.2cm and 32.1kg in 2019; while the median TVOL decreased from 3.10ml to 2.61ml. Iodine supplementation measures can affect TVOL; after exclude iodine effects, the median TVOL was increased with the height and weight. On the other side, after excluding the influence of height and weight, the median TVOL remained decreased. Only age, weight and salt iodine were significant associated with TVOL in multiple linear models. Development of height and weight in children is the evidence of improved nutrition. The decreased TVOL caused by iodized salt measures conceals the increase effect of height and weight on TVOL. Age, weight, and salt iodine affect TVOL significantly.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Halliday ◽  
A Vazir ◽  
R Owen ◽  
J Gregson ◽  
R Wassall ◽  
...  

Abstract Introduction In TRED-HF, 40% of patients with recovered dilated cardiomyopathy (DCM) relapsed in the short-term during phased withdrawal of drug therapy. Non-invasive markers of relapse may be used to monitor patients who wish a trial of therapy withdrawal and provide insights into the pathophysiological drivers of relapse. Purpose To investigate the relationship between changes in heart rate (HR) and relapse amongst patients with recovered DCM undergoing therapy withdrawal in TRED-HF. Methods Patients with recovered DCM were randomised to phased withdrawal of therapy or to continue therapy for 6 months. After 6 months of continued therapy, those in the control arm underwent withdrawal of therapy in a single arm crossover phase. HR was measured at each study visit. Mean HR and 95% confidence intervals (CI) were calculated at baseline, 45 days after baseline, 45 days prior to the end of the study or relapse and at the end of the study or relapse. Patients were stratified by treatment arm and the occurrence of the primary relapse end-point. Heart rate at follow-up was compared amongst patients who had therapy withdrawn and relapsed versus those who had therapy withdrawn and did not. ANCOVA was used to adjust for differences in HR at baseline between the two groups. Results Of 51 patients randomised, 26 were assigned to continue therapy and 25 to withdraw therapy. In the randomised and cross-over phases, 20 patients met the primary relapse end-point; one patient withdrew from the study and one patient completed follow-up in the control arm but did not enter the cross-over phase. Mean HR (standard deviation) at baseline and follow-up for (i) patients in the control arm was 69.9 (9.8) & 65.9 (9.1) respectively; (ii) for those who had therapy withdrawn and did not relapse was 64.6 (10.7) & 74.7 (10.4) respectively; and (iii) for those who had therapy withdrawn and relapsed was 68.3 (11.3) & 86.1 (11.8) respectively [all beats per minute]. The mean change in HR between the penultimate visit and the final visit for those who had therapy withdrawn and did not relapse was −2.4 (9.7) compared to 3.1 (15.5) for those who relapsed. After adjusting for differences in HR at baseline, the mean difference in HR measured at follow-up between patients who underwent therapy withdrawal and did, and did not relapse was 10.4bpm (95% CI 4.0–16.8; p=0.002) (Figure 1 & Table 1). Conclusion(s) A larger increase in HR may be a simple and effective marker of relapse for patients with recovered DCM who have insisted on a trial of therapy withdrawal. Whether HR control is crucial to the maintenance of remission amongst patients with improved cardiac function, or is simply a marker of deteriorating cardiac function, warrants further investigation. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation


Author(s):  
Vagner de Alencar Arnaut de Toledo ◽  
Regina Helena Nogueira-Couto

This experiment was carried out to study the internal temperature regulation of a colony of Africanized honey bees (AFR), compared with hybrid Caucasian (CAU), Italian (ITA), and Carniolan (CAR) bees, during the period of one year and different size hives located in a sub-tropical region. The instant internal temperature, 33.7 ± 1.5° C for the AFR, 33.5 ± 1.4° C for the CAU, 33.7 ± 1.5° C for the ITA and 33.8 ± 1.4° C for the CAR, did not show any significant difference (P>0.05). The maximum temperature (36.1 ± 2.3° C) was statistically different (P<0.05) from the minimum (27.6 ± 5.3° C). There was no difference (P>0.05) in the mean internal temperature, between the nucleus (31.7 ± 6.3° C) and the brood nest (32.1 ± 5.3° C) measured between two and four o'clock in the afternoon.


1998 ◽  
Vol 66 (2) ◽  
pp. 383-387 ◽  
Author(s):  
M. Khalid ◽  
W. Haresign ◽  
D. G. Bradley

AbstractThis study consisted of two experiments. In experiment 1, stress responses of sheep which were restrained either in a laparoscopy cradle or a roll-over cradle were compared. The results of this experiment indicated that restraint in roll-over cradle is less (P < 0·05) stressful than that in a laparoscopy cradle when assessed in terms of the elevation and duration of both the mean heart rate and plasma cortisol responses. Experiment 2 compared the stress responses of sheep subjected to restraint in a laparoscopy cradle, restraint in a laparoscopy cradle with intrauterine artificial insemination (AI) by laparoscopy, minimal restraint with cervical AI or restraint in a roll-over cradle plus foot-trimming. All treatments resulted in significant elevations in both heart rate and plasma cortisol concentrations (F < 0·001). The peak heart rate was significantly (P < 0·05) higher in ewes subjected to cervical AI than in those subjected to intrauterine insemination, with other treatments intermediate. The peak cortisol response did not differ among different treatments. The duration over which both the mean heart rate and -plasma cortisol concentrations remained significantly elevated above pre-treatment concentrations did not differ among treatment groups. The results of this study suggest that while restraint using a laparoscopy cradle is more stressful than that using a rollover cradle, the stress inflicted by intrauterine insemination by laparoscopy itself is no greater than that due to restraint using the laparoscopy cradle alone, cervical AI or the management practice offoot-trimming using a rollover cradle.


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