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Biomedical subjects

R Eggertsen

Publications and source records attributed to R Eggertsen.

At least 19 recordsLinked to original sources
PubMed2006

Effect of lifelong iodine supplementation on thyroid 131-I uptake: a decrease in uptake in euthyroid but not hyperthyroid individuals compared to observations 50 years ago.

BACKGROUND: In Sweden, iodine has been added to table salt (10 mg/kg) since 1936; this amount was increased in 1966 to 50 mg/kg. OBJECTIVE: To investigate a euthyroid Swedish population (n = 44, 60-65 years) with its entire lifespan with iodine supplementation as for 24-h 131-I uptake (24 h IU) and thyroid nodularity (thyroid scintigraphy). To compare the euthyroid 24 h IU with uptake of thyrotoxic individuals, and with observations from 1955. METHODS: The 24 h IU was used in euthyroid individuals after oral administration of 0.1 MBq/2.7 microCi radioiodine and imaging of the thyroid gland was carried out using 99mTc-pertechnetate. RESULTS: In 1999-2000, the mean 24 h IU in the euthyroid individuals was 21% (range 11-33%) and the normal (central 95%) reference interval was 14-30%. Scintigraphy suggested multinodular goitre in three euthyroid individuals. In Graves' patients (n = 53, 50-65 years), the mean 24 h IU was 61% (range 29-89%). In 1955, the 24 h IU in euthyroid individuals was higher (38%, range 10-70%), while hyperthyroid patients had uptake values similar to those recorded in the present investigation (mean 62%, range 40-90%). CONCLUSIONS: The population sample studied had to be small for ethical reasons. We conclude that the reference interval for 24 h IU is 14-30% in this population that had spent its entire lifespan with iodine supplementation. This is lower than that recorded in a Swedish euthyroid population half a century ago having had low-grade table-salt iodine supplementation for 20 years. Values for hyperthyroid patients, however, do not appear to have been affected likewise.

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PubMed2006

Determination of intrathyroidal iodine by X-ray fluorescence analysis in 60- to 65-year olds living in an iodine-sufficient area.

OBJECTIVES: X-ray fluorescence (XRF) is a non-invasive method for determining the iodine content of the thyroid gland in vivo. In spite of the obvious clinical value of such a method in situations of iodine deficiency or iodine overload, the method has not so far been widely used. The objective was to investigate the applicability of the XRF method in a larger number of subjects. DESIGN AND SUBJECTS: The study comprised 37 individuals, aged 60-65 years, who had spent their entire life with iodine supplementation through iodinated table salt. Individuals with (previous) thyroid disease were excluded. The individual thyroid function had previously been evaluated by measurements of thyroid-related hormones, thyroid volume and 131-Iodine (131I) uptake which indicated a sufficient iodine intake of the population in the area. Iodine in the right thyroid lobe in each subject was examined using XRF. RESULTS: The mean thyroid iodine concentration was 0.4 mg mL(-1), corresponding to a mean total iodine content of 5.2 mg (range 0.9-20.2). There was a pronounced difference between individuals. No correlation was found between iodine concentration and 131I uptake or thyroid volume. Neither was iodine content and 131I uptake correlated. CONCLUSIONS: In a population living under iodine-sufficient conditions, a large variation of iodine stored in the thyroid is compatible with euthyroidism. Determination of the iodine pool by XRF investigation is feasible in a clinical setting and the method offers a unique possibility to study the intrathyroidal iodine pool in subjects with thyroid disease. The low radiation dose enables the use of the method in pregnant women and also in young individuals.

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PubMed2004

Urinary iodine and thyroid volume in a Swedish population.

OBJECTIVE: To evaluate the present efficacy of an iodine supplementation programme working in Sweden since 1936 by studying the iodine excretion in urine and determining the thyroid volume in a population in a semi-rural community. DESIGN: A cross-sectional population screening comprising three age groups with randomly selected individuals: group 1 (children): 7-9 years, n = 61 (invited 70); group 2 (teenagers): 15-17 years, n = 61 (invited 63), and group 3 (adults): 60-65 years; n = 57 (invited 73). MAIN MEASUREMENTS: Urinary iodine was measured spectrophotometrically; thyroid volume by ultrasonography. RESULTS: The median values for urinary iodine concentration in the three age groups were 194 microg L(-1), 246 microg L(-1) and 190 microg L(-1), respectively, indicating an adequate iodine intake. In the 7-9 year olds, the median value of the thyroid volume was 4.7 mL, which coincides with the recently established upper limit of normal children of that age, 4.0-4.8 mL (ICCIDD, International Council for control iodine deficiency disorders). One eight-year-old boy had a pronounced goiter. Four teenagers and one adult were found to have an enlarged thyroid gland according to earlier established reference volumes (15 years >16 mL; adults > 25 mL). CONCLUSION: We conclude that the iodine intake in our region is sufficient in age groups ranging from young children to pre-retirement adults.

Adolescent↗
PubMed2001

Screening for thyroid disease of 15-17-year-old schoolchildren in an area with normal iodine intake.

OBJECTIVE: The prevalence of thyroid disease in Swedish schoolchildren is today insufficiently known. The aim of the study was therefore to determine the prevalence of abnormal thyroid function and thyroid autoimmunity in teen-age schoolchildren and to compare the findings with a healthy control group of 60-65-year-old inhabitants from the same community. SETTING: A semirural community of approximately 15,000 inhabitants. DESIGN: Cross-sectional study. MAIN OUTCOME MEASURES: Thyroid volume and serum concentrations of serum thyrotropin (TSH), total and free thyroxine (T4), total and free 3,5,3'-triiodothyronine (T3), and antithyroperoxidase antibodies (TPOAb). RESULTS: Four schoolchildren (7%, 59 screened) had elevated TPOAb concentration, three of the subjects being girls (8%). One girl with a goitre was overtly hypothyroid and one girl showed borderline-high serum TSH concentration suggesting subclinical autoimmune thyroid disease. One euthyroid boy had a goitre and high concentration of TPOAb. The serum free T3 concentration was significantly higher in 15-17-year-old than 60-65-year-old (7.4 vs. 6.4 pmol L(-1), P < 0.001). The concentrations of other thyroid hormones and of TSH in 15-17-year-old did not differ from those of the 60-65-year-old. CONCLUSIONS: We found three cases of thyroid disease in need of immediate attention or later follow-up. The prevalence of autoimmune thyroid disease was high as indicated from TPOAb measurements. Thyroid tests including TPOAb measurement should be performed on wide indications when teenagers seek medical advice. The reference intervals for teen-age children for commonly used first line tests (TSH and free T4) do not differ from those for adults.

Adolescent↗
PubMed2000

Relations between Helicobacter pylori, thyroid disease and cardiovascular risk factors in a 56-65-year-old population.

OBJECTIVE: To estimate the prevalence of and relation between Helicobacter pylori (HP) and thyroid disease in a 56-65-year-old population with cardiovascular risk factors. DESIGN: Cross-sectional study including every second individual in the age group. SETTING: The primary health care district of Mölnlycke, with about 14,000 inhabitants. PATIENTS: 170 men and 217 women aged between 56 and 65 years. MAIN OUTCOME MEASURES: Anthropometric (body mass index (BMI), waist/hip ratio (WHR)) and blood pressure measurements, biochemical analyses, including s-TSH, s-FT4 and HP serology. RESULTS: There was a high prevalence of metabolic risk factors in this pre-retirement group of individuals. The prevalence of HP was 42% in both men and women. Only a significant correlation between HP and WHR was seen in men. CONCLUSIONS: No reason could be found for including analysis of HP and thyroid tests in screening programmes for cardiovascular risk factors in men and women.

Age Distribution↗
PubMed1999

[Ultrasonic measurement of residual urine is considerate and reliable].

The measurement of residual urine is often an invaluable aid in the examination of patients with prostate enlargement. As a result of the increasing scope of pharmacological treatment options in cases of such urinary problems, more such investigations are now being performed in primary care. Traditionally, residual urine has been measured by catheterisation of the urethra, which is associated with a risk of infection and other complications. As experience of ultrasound measurement of residual urine in 30 patients at a primary health centre suggests it to be a rapid, easily tolerated method unaccompanied by complications, it would seem to be an appropriate procedure even for use in the elderly with any of a variety of chronic diseases. It was also found easy for various categories of staff to learn.

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PubMed1998

The relations of microalbuminuria to ambulatory blood pressure and myocardial wall thickness in a population.

OBJECTIVES: To examine the relationship between microalbuminuria (20-200 microg min(-1)) and 24 h ambulatory blood pressure and heart wall thickness, in a representative population sample of men and women aged 56-65 years. DESIGN: Every second individual aged 56-65 years (n=488) in the district, was invited for a health examination, which included determination of urinary albumin and creatinine (overnight sample). The highest and lowest decentile of urinary albumin/creatinine ratio were compared. SETTING: The district of the Primary Health Care and Research Centre of Mölnlycke, Sweden. SUBJECTS: After excluding 2 individuals with a urinary albumin excretion exceeding 200 microg min(-1). 26 subjects (group 1) could be compared with 27 subjects in the lowest decentile (group 2). MAIN OUTCOME MEASURES: Comparison between the determinations of the ambulatory blood pressure and echocardiographic variables in the two groups. RESULTS: Group 1 had significantly higher 24 h ambulatory blood pressure, and heart septum and posterior wall thickness as well as significantly higher fasting blood glucose and serum triglyceride concentrations. The differences in blood pressure (P < 0.05) but not heart wall thickness remained significant (P<0.05) after excluding subjects with hypertension, angina pectoris, treated diabetes mellitus, and/or history of heart or cerebrovascular disease. When excluding individuals with both treated and untreated diabetes mellitus, fasting blood glucose concentration was higher in group 1. The waist-hip ratio, weight and body mass index did not differ between the groups. CONCLUSIONS: The findings indicate that microalbuminuria is related to signs of cardiovascular and metabolic influence and therefore could be a valuable tool for grading the risk of later cardiovascular morbidity.

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PubMed1997

[A simple health control for the elderly. Screening for vitamin B12 deficiency and thyroid disease].

Screening for vitamin B12 deficiency and thyroid disease is cheap and enables early diagnosis to be made and treatment to be started while it is still simple and can prevent the development of such serious conditions as dementia, depression, or irreversible tissue damage. In 1995-6, 83% (126/151) of all 75-year-olds in Härryda, a district (population 28,500) to the east of Gothenburg, agreed to undergo a health control designed to detect hypo- or hyper-thyroidism or vitamin B12 deficiency among elderly residents without symptoms (or with atypical symptoms not easily recognised). Of the 126 participants, four (3%) had low plasma cobalamin (vitamin B12) levels (a figure similar to or lower than those reported by others), and were treated with vitamin B12 after further examination; eight (6%) had serum thyroid stimulating hormone (TSH) levels below the lower normal limit, though further examination showed all eight to be euthyroid; and two (1.6%) were diagnosed as being hypothyroid (a lower prevalence than figures reported elsewhere), and were treated with laevothyroxine. The findings suggest that such screening might be useful in primary care. However, the clinical diagnosis of vitamin B12 deficiency, and of hypo- or hyperthyroidism, is often difficult, especially in the elderly; and although a low serum TSH level is also considered to be a reliable marker of hyperthyroidism, like others this study showed that it may occur even in the absence of disease. Thus, serum TSH and plasma B12 levels are useful screening variables, but need to be complemented by other tests before diagnosis is set.

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PubMed1993

Effect of coffee on ambulatory blood pressure in patients with treated hypertension.

Effects of caffeine on ambulatory blood pressure, heart rate, renin-angiotensin system, and ANP were studied in patients treated for mild to moderate hypertension in a randomized, double-blind, placebo-controlled, cross-over trial comparing 2 weeks of caffeine-free diet with 2 weeks of regular coffee use. Twenty-three patients (13 men; aged 28-74 years) with treated, mild to moderate essential hypertension and a regular intake of 3-4 cups of coffee daily completed the study. Mean 24-h, day- or night-time ambulatory blood pressure and heart rate were not different between regimens. Nor were there any effects on the renin-angiotensin system while ANP was significantly increased during caffeine intake. Compliance of the dietary regimen was excellent as assessed by serum caffeine concentration measurements. We conclude that habitual coffee drinking did not influence the 24-h blood pressure profiles or cardiovascular hormones in treated hypertensives.

Adult↗
PubMed1993

The value of screening for retinopathy and microalbuminuria in patients with type 2 diabetes in primary health care.

Patients with type 2 diabetes (NIDDM) attending the Primary Care Centre in Mölnlycke, Sweden, were evaluated regarding their metabolic status, microalbuminuria (UAER), and hypertension. An ophthalmological examination was performed, and two diagnostic methods, slit-lamp biomicroscopy and fundus photography, were compared. Nearly half the patients (42%) had diabetic retinopathy, mainly of the background type. Retinopathy was associated only with the duration of the disease, but the prevalence was as high as 20% within 0-4 years of the diagnosis. Fundus photography was easy to apply, except in the age groups above 80 years, in otherwise healthy and mentally cooperative patients. Fundus photography could not be applied in only 7% of the patients for ophthalmological reasons. The prevalence of microalbuminuria (20-200 micrograms/min) was high--34%--with another 8% above that range. Male sex, mode of antidiabetic treatment, and hypertension were associated with an increased UAER. Screening for retinopathy and microalbuminuria is valuable in primary health care in order to detect treatable diabetic retinopathy and to trace patients with microalbuminuria, a risk factor for clinically overt nephropathy as well as for cardiovascular diseases.

Adult↗
PubMed1992

Screening of an elderly population in primary care for primary hyperparathyroidism.

In order to assess the diagnostic outcome of a screening for primary hyperparathyroidism (PHPT) in an elderly population, we determined ionized calcium in serum from 368 individuals participating in a health control at Mölnlycke Primary Care Centre (200 women, 168 men; age range 75-95 years); four-fifths of the individuals living in their homes, the remainder in homes for aged or nursing homes. Intact parathyroid hormone was determined in the samples with oinized calcium concentration greater than mean + 3SD of the truncated population sample, and these individuals were also recalled for another blood sample. Moderate hypercalcaemia, probably due to PHPT, was found in eight individuals (2% of the complete sample, 3% of the women), five having neuropsychiatric or neuromuscular symptoms consistent with PHPT. Surgical intervention is probably indicated in only a small proportion of elderly patients. We conclude that optimal benefits in relation to costs of screening for PHPT in old people will depend on the availability of a safe and simple pharmacological treatment that could determine any causal relationship between hypercalcaemia and symptoms.

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