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Biomedical subjects

A Toft

Publications and source records attributed to A Toft.

16 recordsLinked to original sources
PubMed1997

Thyroxine suppression therapy in Graves' disease.

A recent Japanese report of a novel 'block-and-replace' regime for Graves' hyperthyroidism in which thyroxine was continued alone after the combination therapy was stopped was associated with a negligible relapse rate of less than 2%. Such a finding has the potential to revolutionize the management of Graves' disease but a similarly large study from Scotland failed to confirm any benefit from the new treatment. Apart from obvious differences in race and dietary iodine there is no adequate explanation for the discrepant results. In all studies reporting a fall in thyrotropin (TSH) receptor antibodies (TRAb) and/or relapse rates following conventional or novel 'block-and-replace' regimes, serum TSH concentrations were often elevated in the control groups treated with antithyroid drugs alone. Theoretically, this could lead to continued expression of thyroid cell surface antigen, increased production of TRAb and an adverse effect on remission rates. This, however, fails to explain the extraordinary low remission rates of the original study from Japan and, in the meantime, there is no good reason to adopt the novel regime, at least in Caucasians.

Antithyroid Agents↗
PubMed1997

Infectious mononucleosis treated by an antihistamine: a comparison of the efficacy of ranitidine (Zantac) vs placebo in the treatment of infectious mononucleosis.

This study investigated whether the course of infectious mononucleosis was influenced by medication with ranitidine (Zantac). A double-blind, placebo-controlled study enrolled 117 patients and either ranitidine 300 mg or placebo were given twice daily for 2 wk. Patients were examined on day 5, 10, 15 and 30. Efficacy variables included severity and duration of fever, scores of cervical lymph node size and tonsil size, eating problems, fatigue, influence on general condition, the use of analgesics and blood analyses. Results were analysed in 91/117 patients. Small differences were found between treatment groups in favour of the active drug. However, they were not statistically significant. After 2 wks of treatment abnormal 'liver enzymes' (ALAT/ASAT) were found in 13/48 (0.27) of the ranitidine group in contrast with 18/36 (0.50) of the placebo group (P = 0.03). The conclusion is that the course of infectious mononucleosis is little influenced by ranitidine treatment for 2 wks. The faster normalization of the 'liver enzymes' may reflect modulation of the immune system by ranitidine.

Alanine Transaminase↗
PubMed1996

Lack of effect of thyroxine in patients with Graves' hyperthyroidism who are treated with an antithyroid drug.

BACKGROUND: Antithyroid drugs are effective in patients with hyperthyroidism due to Graves' disease, but the rate of recurrence after treatment is high. In a recent Japanese study, adjunctive treatment with thyroxine (T4) was associated with a recurrence rate 20 times lower than that among patients who received only an antithyroid drug. If these results are confirmed, combined therapy with an antithyroid drug and T4 might become the treatment of choice for all patients with Graves' hyperthyroidism. METHODS: We treated 111 patients (89 women and 22 men) who had Graves' hyperthyroidism. All patients initially received 40 mg of carbimazole daily for one month. Then one group received carbimazole alone for 17 months (52 patients), and the other group received carbimazole plus T4 for 17 months and T4 alone for 18 months (59 patients). In the carbimazole group, the dose was adjusted after one month to maintain a normal serum thyrotropin concentration. In the carbimazole-T4 group, the dose of carbimazole was not changed, but 100 micrograms of T4 per day was added to the regimen and the dose was adjusted to maintain an undetectable serum thyrotropin concentration (< 0.04 microU per milliliter). RESULTS: At the time of our analysis, 53 of the 111 patients had completed at least 3 months of follow-up (median, 12 months) after carbimazole was withdrawn. Hyperthyroidism recurred in eight patients in each group after a mean (+/- SD) of 6 +/- 4 months in the carbimazole group and 7 +/- 4 months in the carbimazole-T4 group. There was no difference between the recurrence rates in the two groups, despite the fact that serum thyrotropin concentrations were undetectable in 73 percent of patients in the carbimazole-T4 group on at least 75 percent of their visits. CONCLUSIONS: The administration of T4 to patients with Graves' disease during carbimazole treatment and after its withdrawal neither delays nor prevents the recurrence of hyperthyroidism.

Adult↗
PubMed1994

Severe chronic inflammation of the mucous membranes in the eyes and upper respiratory tract due to work-related exposure to hexavalent chromium.

Chronic inflammation of the skin and mucous membranes following prolonged exposure to high doses of toxic hexavalent chromium is well known in the occupational medical literature. Perforation of the nasal septum is a cardinal clinical feature. Late development of cancer in the respiratory system is established. A recently diagnosed case with an unusually severe affect on the eyes is described. The industrial usage of chromium and its toxicological profile is reviewed.

Aged↗
PubMed1982

Double-blind comparison between beclomethasone dipropionate as aerosol and as powder in patients with nasal polyposis.

Beclomethasone dipropionate as a pressurized aerosol is effective in nasal polyposis, but the efficacy is only moderate. In these partly-blocked noses, it seems possible that the insufflated drug in powder form is better distributed over the mucous membrane than the pressurized aerosol. To test this hypothesis, we treated forty-two patients with nasal polyposis with intranasal beclomethasone dipropionate as a powder and as a pressurized aerosol in a double-dummy, cross-over design. There was no difference between the treatments in sixteen patients, while in twelve cases there was a preference for beclomethasone dipropionate as aerosol, and in fourteen, for the powder form. Fourteen found the aerosol most irritating and nineteen, the powder. Thus, in a group of polyp patients there were no significant differences between the two application forms, but possibly there is a need for both aerosol and powder, as there appeared to be differences in the individual responsiveness to the two types of intranasal medication. Blind microscopy of wiped nasal-smears before and after beclomethasone dipropionate treatment showed a reduction of basophilic cells, and counting of sneezes after medication demonstrated a reduction in the number of sneezes. These results suggest that a reduction of epithelial mediator-cells and of irritant receptor-sensitivity are of importance for the efficacy of topical steroids in rhinitis.

Adult↗
PubMedDate not supplied

Lymphocyte ATPase activity in patients with carcinoma of the larynx. A follow-up study on 45 patients.

Mitochondria-related Mg ATPase activity was assayed in lymphocytes isolated from the blood in 45 patients with epidermoid carcinomas of the larynx. Increased activity was found in 11 patients and normal or subnormal activity in the remaining cases. No correlation could be demonstrated between the magnitude or the spreading of the malignancy as recorded by the TNM classification and the ATPase activity. In 36 patients determinations were carried out repeatedly during a period from 6 to 20 months following therapy and after 3 years a final follow-up on all patients was done. All patients received high-voltage radiotherapy and in 7 patients additional partial or total laryngectomia was carried out, one patient had bilateral neck dissection. After radiotherapy the ATPase activity decreased significantly in 17 patients while it either remained normal or increased temporarily in the rest. No correlation was found between the course of the disease and the initial ATPase activity or the pattern of variation in ATPase activity following therapy. Contrary to what resulted from a preliminary study, it is concluded that determination of lymphocyte ATPase activity is of no diagnostic value in patients with laryngeal carcinoma, nor does it offer any prognostic help in determining which patients may relapse or develop metastatic disease.

Adenosine Triphosphatases↗