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Biomedical subjects

M Blichert-Toft

Publications and source records attributed to M Blichert-Toft.

At least 181 records · Page 10Linked to original sources
PubMed1979

Influence of thyroid surgery on voice function and laryngeal symptoms.

A comprehensive examination of voice function and laryngeal symptoms was applied systematically to 20 patients undergoing thyroid surgery. Patients were excluded from the series if there had been previous neck surgery or if postoperative indirect laryngoscopy showed abnormal cord mobility. Examination before operation showed that patients with sporadic non-toxic goitre or medically pre-treated toxic goitre had impaired voice function based on stroboscopy, electro-glottography, phono-oscillometry and determination of voice range, phonation time, pitch, and peak flow. Three months after thyroid surgery the voice function was significantly improved although not normal in non-toxic goitre patients, whereas the voice function in patients with thyrotoxicosis was unchanged. The number of laryngeal symptoms was significantly reduced in non-toxic goitres following surgery and unaltered in the group with thyrotoxicosis.

Adolescent↗
PubMed1979

Influence of age on the endocrine-metabolic response to surgery.

The pathogenesis of the increased operative risk in elderly patients is unknown. From a theoretical point of view, a change in endocrine-metabolic response might be involved. In the present study, a battery of hormonal and metabolic variables were measured in eight young and eight elderly healthy males undergoing elective inguinal hernial repair under general anesthesia. Blood was drawn before induction of anesthesia, at skin incision, and one, two, and six hours after skin incision. The findings were: 1) Plasma cortisol increase was significantly higher in elderly than in young controls. 2) Plasma renin level was lower in old age, but renin-aldosterone and electrolyte response patterns were alike in the two groups. 3) Thyroid parameters, in terms of serum T4, serum T3, serum rT3, and T3-resin uptake, responded normally to surgery and showed no age-related differences. 4) The hyperglycemic response was not significantly influenced by age indicating unchanged glycoregulatory mechanisms also verified by determinations of plasma catecholamines, cAMP, and insulin. 5) Blood lymphocyte count was constantly lower in elderly than in young and decreased with time, but the age-related difference was not significant. 6) Blood polymorphonuclear leukocytes showed an increase of the same magnitude in both age groups, although at a significantly slower rate in the elderly. It is concluded that age affects some aspects of the initial endocrine-metabolic response to surgery.

Adult↗
PubMed1979

Comparison of pituitary-adrenocortical response to hypoglycaemia and surgery.

The hypothalamic-pituitary-adrenocortical (HPA) responses to the hypoglycaemic stimulus and to operation (laparotomy) are compared. The studies were carried out in eight patients who were subjected to insulin-induced hypoglycaemia on the day before elective abdominal surgery. Plasma corticotrophin (ACTH) and plasma cortisol concentration increases were virtually indentical during the two procedures, which suggests that hypoglycaemia and surgical trauma are comparable stress factors and that the hypoglycaemia test is reliable in predicting the HPA responses to major surgical trauma.

Adrenocorticotropic Hormone↗
PubMed1979

Plasma corticotropin and cortisol in patients with pituitary adenomas.

Plasma ACTH and cortisol were measured during insulin-induced hypoglycemia in 39 patients with a pituitary adenoma or after hypophysectomy and in 26 healthy persons. Adrenocortical insufficiency was defined as failure to increase plasma cortisol to at least 500 nmol/liter (18 microgram/dl) during hypoglycemia. No proper distinction was possible between patients with normal and impaired cortisol response to hypoglycemia on the basis of the ACTH results. When all 39 patients were compared to the 26 controls, the cortisol results differed significantly, but those of ACTH did not. These results demonstrate a limited value of ACTH measurements in secondary adrenocortical failure.

Adenoma↗
PubMed1979

Acute gastrointestinal bleeding detected with abdominal scintigraphy using technetium-99m-labeled albumin.

In 24 patients admitted with gastrointestinal bleeding 36 scintigraphic studies of the abdomen were performed after intravenous injection of technetium-99m-labeled albumin. In 12 patients bleeding from the esophagus, stomach, duodenum, biliary tract, or colon was visualized. In the other 12 patients, in whom the bleeding seemed to have subsided, the investigation showed no scintigraphic signs of hemorrhage. Scintigraphy was also negative in five controls who had no bleeding. The method is non-invasive and easy to perform. Our study suggests that it is reliable, but a controlled trial is necessary to evaluate the diagnostic value of the method.

Acute Disease↗
PubMed1979

The prophylaxis of septic complications in colo-rectal surgery. A controlled trial of metronidazole and oxytetracycline.

The prophylactic effect of systemic metronidazole on infectious complications following elective colo-rectal surgery was compared with the prophylactic effect of oxytetracycline. Allocation to receive metronidazole or oxytetracycline was random. A total of 137 patients were accepted for the trial, 67 receiving metronidazole and 70 oxytetracycline. The numbers of abdominal wound infections, intra-abdominal infections, fever and deaths were few in both groups, and the differences statistically insignificant. Clinically significant side effects of the antimicrobial agents were not observed. The influence of the antimicrobial agents on colonic flora was also studied. No significant difference in the effect on colonic anaerobic flora was demonstrated, whereas the aerobic flora was significantly suppressed by oxytetracycline. It is concluded that systemic metronidazole, although acting solely on the anaerobic flora, is as effective as oxytetracycline in preventing postoperative infectious complications following elective colo-rectal surgery. The prophylactic use of metronidazole is advocated.

Administration, Oral↗
PubMed1978

Inhibition of aldosterone response to surgery by saline administration.

The renin-angiotensin system, ACTH and hyperkalaemia are known to induce increased plasma levels of aldosterone. In order to assess the relative significance of these mechanisms during surgical stress, aldosterone, cortisol and electrolytes in plasma were measured in 12 otherwise healthy women during and after cholecystectomy. The patients received either isotonic sodium chloride or 5 per cent glucose in water during the experimental period of 22 h. The results showed that the pronounced increase of aldosterone and the concomitant decrease of sodium in plasma found in patients given glucose in water could almost be inhibited by the administration of saline. Cortisol and potassium concentrations were identical in the two groups of subjects. It is concluded that the aldosterone response to surgery is mainly mediated via the renin-angiotensin system. This response is probably due to a reduced sodium content or volume of extracellular fluid, since it could almost be inhibited by administration of sodium chloride. The rationale of saline restriction during and after surgery is questioned.

Adult↗
PubMed1978

TSH response pattern to TRH test and optimum time of blood sampling in sporadic euthyroid goitre.

Attempts were made to estimate the response pattern of thyrotrophin (TSH) to thyrotrophin-releasing hormone (TRH) and the optimum time of blood sampling in patients with sporadic euthyroid goitre. Of the 65 subjects studied, 21 served as a reference group and 44 were patients with sporadic euthyroid goitres, divided into diagnostic subgroups according to type of goitre. Patients with a single autonomous thyroid adenoma were excluded. The classification of goitre was based on clinical features, thyroid function tests, thyroid imaging studies using 99mTc pertechnetate uptake, and examination of thyroid specimens originating from selective goitre resection carried out after the laboratory investigations. A standardized i.v. TRH test was performed in all probands and the TSH response was followed for 60 min postinjection. There was a definite trend towards lack of response with increasing nodularity of the thyroid gland. Moreover, no further information concerning the TSH response pattern was achieved by extending the blood sampling period beyond the +20 min limit of the time axis. The study lends support to the view that increasing functional autonomy is a general trend in goitre evolution.

Adult↗
PubMed1978

Effect of selective goitre resection on absent thyrotrophin response to thyrotrophin releasing hormone in idiopathic euthyroid goitres.

Absent thyrotrophin (TSH) response to thyrotrophin releasing hormone (TRH) was found in ten of fifty consecutive nodular goitrous patients who were clinically and biochemically euthyroid. These ten patients together with a reference group engaging fifty-eight healthy individuals matched for sex, age, and geographic region form the basis of the present study. Patients with autonomously functioning single adenomata were excluded from the investigation. In the patient group, values of serum thyroxine (T4), free T4-index, and serum TSH did not differ significantly from those recorded in the reference group, whereas serum triiodothyronine was found to be significantly higher in the patients, although within the normal range. After selective resection of the goitre, the TSH responsiveness to TRH recovered completely. Routine indices of thyroid function, however, demonstrated no major deviation from pre-operative levels. During a follow-up period of 1 year, no systematic alterations were recorded in TSH response to TRH nor in the thyroid function tests, indicating maintenance of euthyroidism with restored normality within the pituitary-thyroid axis. The present study lends support to the view that increasing functional autonomy apparently is a common trend in goitre evolution in a non-endemic area.

Adult↗
PubMed1978

Discrepancy between ACTH and cortisol responses to insulin induced hypoglycaemia.

The purpose of this study was to assess the normal relationship between plasma ACTH and cortisol during insulin induced hypoglycaemia. Twenty-six healthy persons were studied. Peak plasma concentration and the amounts of ACTH and cortisol secreted during hypoglycaemia were compared. There was no significant correlation between the ACTH and cortisol values. The ACTH responses varied significantly more than those of cortisol. This probably signifies an over-capacity of ACTH secretion in comparison to the secretory capacity of the adrenal cortex.

Adrenocorticotropic Hormone↗
PubMed1978

Reliability of the 30-minute ACTH test in assessing hypothalamic-pituitary-adrenal function.

An insulin hypoglycemia test and a 30-min ACTH test were performed in 90 patients with proved or suspected hypothalamic-pituitary-adrenal hypofunction and in 10 normal subjects. The peak plasma cortisol concentration during hypoglycemia and the cortisol concentration at 30 min after injection of 250 micrograms corticotropin 1-24 were compared. A very close correlation (r = 0.92) was found between the the two concentrations, with no major discrepancy in any case. It is concluded that the short ACTH test accurately reflects the integrated hypothalamic-pituitary-adrenal function, as assessed by the insulin hypoglycemia test.

Adenoma↗