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Biomedical subjects

A Hillis

Publications and source records attributed to A Hillis.

42 records · Page 3Linked to original sources
PubMed1979

Hepatitis B surface antigenemia in renal transplant recipients. Increased mortality risk.

To determine effects of circulating hepatitis B surface antigen (HBsAg) on patient survival following renal transplantation, we studied 168 recipients of cadaveric grafts in whom HBsAg status was defined at transplantation by comparison of survivorships determined by actuarial life-table methods. Survival in HBsAg-positive recipients, as compared with those who were HBsAg-negative at the time of transplantation, was markedly diminished. Although graft survival appeared to be favored in the HBsAg-positive group in the early posttransplant period, the apparent protective effect was lost at nine months after grafting and thereafter, due to increased mortality in the HBsAg-positive recipients. Deaths in the antigenemic subjects were principally due to infections other than hepatitis and to cardiovascular events. We conclude that preexisting HBs antigenemia forebodes an ominous outcome for immunosuppressed renal transplant recipients, although hepatic disorders do not account for most deaths.

Cadaver↗
PubMed1979

A mathematical model for the epidemiologic study of infectious diseases.

Many infectious diseases have been hypothesized to represent common virus infections in which only small proportions of cases result in clinically recognizable disease. In order to find a method of studying this class of diseases, a mathematical model of the age distribution of clinical disease was developed using poliomyelitis as a prototype. The model is shown to fit the age distribution of reported poliomyelitis in a variety of localities before the use of artificial immunization. The true yearly rate of infection is easily estimated and ranges from .11 in rural Sweden to 1.20 in Chile. The model accounts for several major features of poliomyelitis epidemiology, including the shift to older ages and the high rate of clinically apparent disease which were frequently observed in populations which could be expected to have a comparatively low rate of spread. An examination of the age distribution of other diseases by these methods may provide a method of identifying other common infections which only occasionally result in clinically apparent disease.

Age Factors↗
PubMed1977

Associations of hepatitis B surface antigenemia with HLA locus B specificities.

To test whether HLA histocompatibility phenotypes might be associated with circulating hepatitis B surface antigen (HBsAG), we performed chisquare and Scheffé analyses on findings in 144 renal patients with known HLA types and HBsAg status. A significant relation between locus B HLA type (or types) and HBS antigenemia was demonstrated (P = 0.01, adjusted for dual testing) with positive associations suggested between Bw15, Bw17 and Bw35 types and transient or persistent (or both) antigenemia. The latter associations individually were statistically significant only if multiple testing was disregarded, but the contrast by the Scheffé method between the three implicated specificities and all other specificities was significant, even after adjustment for multiple testing (P less than 0.02). Associations of genetically determined HLA specificities with hepatitis B infection may constitute the basis for previously observed population differences in HBS Ag prevalences, and suggest that susceptibility to hepatitis B infection may be in part genetically determined.

Alleles↗
PubMedDate not supplied

A new method for evaluating the hepatitis risk of the multiply-implicated donor.

The usual method of estimating probability of infectivity for donors implicated in more than one case of post-transfusion hepatitis fails to take adequate account of the donor's past history and underestimates the risk of infectivity. A corrected method of calculation is presented and shown to give substantially different results.

Blood Donors↗
PubMedDate not supplied

In cirrhotic patients variceal bleeding is more frequent in the evening and correlates with severity of liver disease.

BACKGROUND/AIMS: It has been observed that the portal pressure in cirrhotic patients shows circadian variation and is at a maximum at night. Our aims in this study were a) to evaluate the frequency of upper gastrointestinal (UGI) bleeding from esophageal/gastric varices or portal congestive gastropathy during the day, evening or night shift, and b) to correlate the frequency of bleeding during various shifts with severity of liver disease. METHODOLOGY: At our institution, during the period from January 1997 to June 1995, 15,000 gastrointestinal (GI) endoscopic reports and consultations were evaluated. Episodes of bleeding due to portal hypertension (PH), i.e., esophageal varices, gastric varices or congestive gastropathy, were noted. The time of occurrence of bleeding from PH in various shifts, e.g., day shift (DS), evening shift (ES) or night shift (NS) was determined. The severity of liver disease was classified as A, B or C according to Child's classification. RESULTS: There were 221 episodes of UGI bleeding due to PH in 144 patients. 75.5% of patients presented with hematemesis, whereas 24.5% presented with melena (p < 0.025). Bleeding started during the DS in 39/221 (17.6%), during the ES in 122/221 (55.2%), and during the NS in 60/221 (27.1%). There were 29 (13.1%) patients in Child's A, 75 (33.9%) in Child's B, and 117 (52.9%) in Child's C. Among the 122 bleeders during ES, 85 (69.6%) were in category C. It seems that in these patients UGI bleeding is more frequent during the ES compared to DS and NS (p < 0.0001; chi square; 95% CI: 0.52-0.58). Child's C patients are more likely to bleed during ES compared to Child's A or B patients (p < 0.0001; Odds Ratio: 4.8%; 95% CI: 2.7-8.5). CONCLUSIONS: 1) The majority of the cirrhotic patients with PH who develop UGI bleeding present with hematemesis rather than melena. 2) The bleeding in these patients is more likely to occur during the ES. 3) Child's C patients are more likely to bleed during the ES.

Adult↗