Epidemiology and prevention of clinical and subclinical hypothyroidism.

Iodine deficiency is the most common cause of hypothyroidism worldwide. In persons living in iodine-replete areas, causes are congenital, spontaneous because of chronic autoimmune disease (atrophic autoimmune thyroiditis or goitrous autoimmune thyroiditis [Hashimoto's thyroiditis]), or iatrogenic because of goitrogens, drugs, or destructive treatment for thyrotoxicosis. Screening for congenital hypothyroidism exists and its use prevents mental retardation.

Population screening for autoimmune thyroid disease.

Whether or not healthy adults in the community would benefit from screening for autoimmune thyroid disease is controversial. Although the prevalence of unsuspected overt thyroid disease is low, a significant proportion of subjects tested will have evidence of mild thyroid failure or excess. This article assesses whether subclinical thyroid disease is of sufficient clinical importance to warrant screening and, once detected and confirmed, to justify therapy.

The prevalence of hyperprolactinaemia and association with markers of autoimmune thyroid disease in survivors of the Whickham Survey cohort.

Objective: Few data exist on the prevalence of hyperprolactinaemia in the community. This study was intended to determine the prevalence of hyperprolactinaemia in a sample closely matched to the current British population aged 38 years and over.

Design And Patients: The 1877 survivors at the 20-year follow-up of the Whickham Survey were a cross-sectional sample of the community aged 38 years and over.

The incidence of diabetes mellitus in an English community: a 20-year follow-up of the Whickham Survey.

The original Whickham Survey documented the prevalence of diabetes and lipid disorders in a sample of 2779 adults aged 18 years and over, which matched the British population structure. The aim of the 20-year follow-up study was to determine the incidence and natural history of diabetes. Outcomes in terms of morbidity and mortality at follow-up were determined in over 97% of the original population.

The development of ischemic heart disease in relation to autoimmune thyroid disease in a 20-year follow-up study of an English community.

The original Whickham Survey documented risk factors for cardiovascular disease and the prevalence of thyroid disorders in a sample of 2779 adults that closely matched the British population. A 20-year follow-up study has determined outcomes in terms of morbidity and mortality from ischemic heart disease in over 97% of the original survey population. Analysis of deaths from all causes and from ischemic heart disease showed no association with antithyroid antibody status identified at first survey.

The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey.

Background And Objective: The original Whickham Survey documented the prevalence of thyroid disorders in a randomly selected sample of 2779 adults which matched the population of Great Britain in age, sex and social class. The aim of the twenty-year follow-up survey was to determine the incidence and natural history of thyroid disease in this cohort.

Design, Patients And Measurements: Subjects were traced at follow-up via the Electoral Register, General Practice registers, Gateshead Family Health Services Authority register and Office of Population Censuses and Surveys.

Comparison of non-mydriatic retinal photography with ophthalmoscopy in 2159 patients: mobile retinal camera study.

Objective: To determine whether non-mydriatic Polaroid retinal photography was comparable to ophthalmoscopy with mydriasis in routine clinic screening for early, treatable diabetic retinopathy.

Design: Prospective study of ophthalmoscopic findings according to retinal camera screening and ophthalmoscopy and outcome of referral to ophthalmologist.

Setting: Outpatient diabetic clinics of three teaching hospitals and three district general hospitals.

Renal replacement treatment for diabetic patients in Newcastle upon Tyne and the Northern region, 1964-88.

Objectives: To review the experience of renal replacement treatment in diabetic patients treated in Newcastle upon Tyne and the Northern region from 1964 to 1988, and to compare the morbidity and mortality of diabetic patients treated with dialysis or transplantation with those of matched controls of non-diabetic patients.

Design: Retrospective study of clinical case notes.

Setting: Renal units of the Northern region, particularly that in Newcastle upon Tyne.

The epidemiology of hypothyroidism--an update.

Comparison of studies of the prevalence and incidence of hypothyroidism is hampered by differing definitions and population samples. Using a uniform set of diagnostic criteria, the prevalence of previously undiagnosed, spontaneous, overt hypothyroidism in community-based studies has been estimated between 2-4/1000 total population world-wide. If all cases of previously diagnosed hypothyroidism, previous thyroid surgery and radioiodine treatment are included, this prevalence rises to approximately 10/1000, and if subclinical cases are included, then the prevalence is probably over 50/1000 total population.

A trial of the calcium antagonist nisoldipine in hypertensive non-insulin-dependent diabetic patients.

The antihypertensive and metabolic effects of a new calcium antagonist nisoldipine (10 to 20 mg at night) were investigated in 14 mild to moderately hypertensive non-insulin-dependent diabetic patients (median age 62, range 50-70 years). In a 12-week placebo controlled single blind study, sitting and standing blood pressure were significantly lowered (p less than 0.001).

Recurrent pregnancy-induced polyuria and thirst due to hypothalamic diabetes insipidus: an investigation into possible mechanisms responsible for polyuria.

A young patient developed hypothalamic diabetes insipidus due to histiocytosis in infancy and was satisfactorily treated with Pitressin. As a teenager she no longer had thirst or polyuria after treatment was stopped. These symptoms only returned during her two pregnancies.

Thyroid function in hyperemesis gravidarum.

Twenty-five patients with severe persistent vomiting were studied. On admission they were given the diagnosis of hyperemesis gravidarum. Hyperemesis was defined as vomiting of sufficient severity to warrant admission to hospital and iv therapy, which was not associated with any other condition known to cause vomiting other than the pregnancy itself.

Adipocyte insulin binding and insulin sensitivity in 'brittle' diabetes.

Adipocyte insulin binding and insulin sensitivity to stimulation of lipogenesis were assessed in a group of extremely 'brittle' diabetic patients who were resistant to subcutaneous insulin therapy and had required frequent and prolonged hospital admission. These patients had significantly lower maximum adipocyte insulin binding (1.78 +/- 0.

Mortality from diabetic nephropathy in the United Kingdom.

Deaths in diabetic subjects dying under 50 years of age in the United Kingdom during 1979 have been analysed with special reference to diabetic nephropathy. Fifteen percent of 447 deaths were from nephropathy. Uraemic deaths from nephropathy were particularly common in those whose diabetes was diagnosed under 31 years old, and responsible for over one-quarter of deaths in this age group.

Intermediate acting insulin given at bedtime: effect on blood glucose concentrations before and after breakfast.

Six C-peptide deficient diabetics receiving twice daily mixtures of short and intermediate acting insulins were selected for study because of persistently raised blood glucose concentrations before and after breakfast. They were investigated to assess the effect of moving their evening injection of intermediate acting insulin to bedtime. The patients' usual twice daily insulin treatment was optimised and compared with the bedtime regimen during inpatient metabolic studies and an outpatient crossover study.

Age-associated change in QRS axis: intrinsic or extrinsic ageing?

Human ageing is most usefully conceptualised as an interaction between intrinsic and extrinsic processes. Comparison of age-associated trends in populations living under different environmental conditions provides a method of recognising the effects of extrinsic influences. This paper compares the age-associated trend in mean frontal plane QRS axis in the male adult population of Pukapuka with the trend observed in an age-matched sample from a British population.