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Biomedical subjects

G Hintze

Publications and source records attributed to G Hintze.

32 records · Page 2Linked to original sources
PubMed1988

Effect of voluntary intake of iodinated salt on prevalence of goitre in children.

The availability of iodinated salt containing 20 mg of iodine as iodate/kg salt consumed on a voluntary basis enabled us to investigate its effect on goitre prevalence and iodine excretion in urine in a longitudinal, prospective, randomized study over 4 years. With this salt, under the assumption of a consumption of 5 g salt per day and person, an additional intake of 100 micrograms of iodine can be achieved. The study was performed on initially 334 children (168 boys, 166 girls) at the age of 10 years living in an area of iodine deficiency. After 4 years, 286 children still participated in the study. Initially, goitre prevalence as assessed by palpation was found to be 30.5% (37.4% in girls and 23.8% in boys). Neck circumference was found to be significantly higher in children with goitre compared with those without (30.2 +/- 1.4 vs 29.4 +/- 1.4 cm; P less than 0.001). Iodine excretion in the urine was significantly lower in children with goitre compared with those without (40.4 +/- 16.7 micrograms/g creatinine vs 46.1 +/- 24.9 micrograms/g creatinine; x +/- SD; P less than 0.05). The children were randomly assigned to two different groups: group A (N = 146) was asked to use iodinated salt, group B (N = 188) non-iodinated salt. Over the 4 years, a continuous increase in iodine excretion in urine could be demonstrated in group A.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1987

Iodine vs thyroxine. A changing concept of therapy in endemic goiter?

The hypothesis that goitrogenesis in iodine deficiency can be attributed to the stimulatory effect of thyrotropin (TSH) on the thyroid gland and has long been held to be valid. The task of this review is to describe the reasons why this concept is being challenged. In addition, we report on the autoregulation of the thyroid gland and on in vitro investigations dealing with TSH as a growth factor, which have yielded conflicting results. Finally, we summarize preliminary studies comparing the therapeutic effect of thyroxine and iodine on goiter size. In comparison to thyroxine, iodine application in doses of 300-500 micrograms/day may represent an equally effective way of treatment in areas of endemic goiter, especially in younger patients. In this age group, the risk of side-effects, e.g., iodine-induced thyrotoxicosis, should be low.

Diiodotyrosine↗
PubMed1987

A case of valproate intoxication with excessive brain edema.

A 29-year-old man, who had been treated with sodium valproate for 3 years because of generalized cerebral seizures, ingested a large amount of this drug in an attempt to suicide. The exact amount he had swallowed could not be determined. The patient arrived in the intensive care unit in a deep coma, was intubated, and artificially ventilated. He developed a massive cerebral edema, as proved by computerized tomography (CT). This was supported by electroencephalography (EEG). The measured value for the concentration of valproate in serum was markedly elevated on the day of admission (2300 mumol/l; therapeutic range 350-700 mumol/l). Treatment with sodium thiopental, glycerol, and glucocorticoids was initiated. A second CT scan performed 9 days after admission showed a complete normalization and the EEG yielded a markedly improved pattern. At this point the patient slowly regained consciousness. We conclude that in patients with an acute sodium-valproate intoxication, care should be taken with regard to the development of a severe cerebral edema, which in the reported case could be treated successfully.

Adult↗
PubMed1985

Iodine-induced thyrotoxicosis--a case for subtotal thyroidectomy in severely ill patients.

Iodine-induced thyrotoxicosis (IIT), due to iodine application in high amounts in patients with circumscript or disseminated thyroid autonomy, is complicated by a prolonged course, mainly due on the body's resistance to conservative therapy with thiourea derivates. Therefore, we decided to perform subtotal thyroidectomy in 16 thyrotoxic patients. This is in contrast to the common opinion that surgery should only be performed after normalization of thyroid hormones. In all 16 patients with severe IIT, including three patients with thyroid storm, hormone levels decreased within a few days after surgery to normal or subnormal values and the clinical picture of thyrotoxicosis disappeared. In the case of thyroid storm the signs of disorientation normalized within 1-3 days. One patient died 5 weeks after surgery due to severe concomitant diseases. One patient exhibited transitory respiration distress and another had postoperative hypocalcaemia. In nine patients L-thyroxine replacement became necessary because of subclinical or clinical hypothyroidism. Only by this procedure will the high intrathyroidal storage of iodine and performed hormone be extracted. Surgery as a treatment for thyrotoxicosis should be reserved for patients with severe IIT, where conservative treatment has been shown to be ineffective. Furthermore, in rare selected cases, when a rapid normalization is required, surgery without preoperative treatment seems to be justified. The effect of surgery was impressive in all our cases and there were only minor perioperative complications. Thus, it could be shown that subtotal thyroidectomy may be a rational and effective treatment in severe IIT which should be carefully considered and weighed against other types of therapy.

Adult↗
PubMed1985

Bilateral virilizing adrenal tumor in a 17 year old woman.

We report on a 17 year old female patient with amenorrhea, hirsutism and slight acne. Hormonal blood analyses showed markedly increased levels for dehydroepiandrosteronesulfate, testosterone and androstenedione. Ultrasound investigation revealed a large tumor above the left kidney and a small area above the right kidney, suspicious for a tumor on the contralateral side. This was confirmed by angiography. During surgery, bilateral tumors were removed. Pathological diagnosis was made as bilateral adenomas of the adrenal cortex. Postoperatively, an impressive normalization was observed, accompanied by a rapid decrease of the elevated hormone concentrations. This case is the first report of a bilateral occurrence of a virilizing tumor of the adrenal cortex.

Adenoma↗
PubMed1985

Therapy of endemic goitre: controlled study on the effect of iodine and thyroxine.

Two kinds of medical treatment of endemic goitre (400 microgram of iodine, n=11, and 150 microgram of L-thyroxine, n=12) were compared in a double blind study with a placebo group (n=12) during a period of 12 months and an observation time of three months after cessation of therapy. The means of the neck circumference and of the estimated thyroid volume decreased significantly during treatment in both groups, whereas no significant difference was observed in the placebo group. The results in both therapy groups did not differ significantly from each other. No side effects or symptoms of hyperthyroidism were observed. During treatment the index of free thyroxine (FT4I) increased significantly in both the iodine and the thyroxine group and delta TSH after TRH decreased significantly. Total triiodothyronine (TT3) did not show significant alterations. Three months after cessation of therapy in the thyroxine treated group the mean FT4I dropped into the range before treatment, whereas it remained slightly elevated in the iodine group. In the thyroxine treated group the mean delta TSH was higher than its value before therapy. After withdrawal of iodine, however, the mean delta TSH remained decreased for three months. The study indicates that 400 micrograms of iodine per day may be at least as effective as a standard dose of 150 micrograms of thyroxine to treat endemic goitre in an iodine deficient area.

Adolescent↗
PubMed1985

[Subtotal thyroid resection in severe, iodine-induced hyperthyroidism].

Iodine-induced thyrotoxicosis due to iodine application in high amounts in patients with circumscript or disseminated thyroid autonomy, is complicated by a prolonged course, mainly due to a resistance to conservative therapy with thiourea derivates. We therefore decided to perform an early subtotal thyroidectomy in 24 thyrotoxic patients. This measure is in contrast to the common opinion that surgery should only be performed after normalization of thyroid hormones. In all 24 patients with severe hyperthyroidism, including three patients with thyroid storm, hormone levels decreased within a few days after surgery to normal or subnormal values and the clinical picture of thyrotoxicosis disappeared. In the case of thyroid storm the signs of disorientation normalized within 1-3 days. One patient died five weeks after surgery due to severe concomitant diseases. One patient exhibited transitory respiration distress and another had postoperative hypocalcemia. In 13 patients L-thyroxine replacement became necessary due to subclinical or clinical hypothyroidism. Surgery as a early treatment for thyrotoxicosis should be reserved for patients with severe illness where conservative treatment has been shown to be ineffective. In rare selected cases, when a rapid normalization is required, surgery without preoperative treatment seems to be justified. The effect of surgery was impressive in all our cases and there were only minor perioperative complications.

Adult↗
PubMed1981

[Diagnostic problems of hyperthyroidism in the older age group (author's transl)].

Seventy-seven patients aged more than 60 years from the iodine deficiency area of southern Lower Saxony with hyperthyroidism, diagnosed by assessment of thyroid parameters, showed a nonspecific disease picture with surprising frequency when compared with younger patients. Predominant characteristics were weight loss (86%), general weakness (78%), tachycardia (74%), reduced appetite (66%), exertional dyspnoea (60%), apathy, lack of initiative or depression (48%), and uncharacteristic abdominal complaints (20%). A goitre was not palpable in 30 patients (39%). Laboratory diagnosis was hampered by relative or absolute TBG deficiency and conversion inhibition in the form of a low-T3 syndrome as evidence of non-thyroidal changes in generalised disorders. Neither thyroxine nor triiodothyronine were increased in ten patients (13%). Only by additional routine estimation of the thyroxine-binding index (T3 in vitro test) as indicator of free binding capacity could the diagnosis be ascertained in these cases. The poor prognosis be ascertained in these cases. The poor prognosis of hyperthyroidism in the older age group necessitates generous use of specific diagnostic laboratory investigations in cases with suspicious symptoms.

Age Factors↗