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Biomedical subjects

A J Vogten

Publications and source records attributed to A J Vogten.

At least 19 recordsLinked to original sources
PubMed1992

Estimation of survival probability in cirrhotics. Evaluation of a computer model applicable for decision-making.

In 25 randomly selected, non-alcohol-induced cirrhotics, a simple mathematical model originally designed as the "Mayo-model" for the prediction of prognosis and survival in patients with primary biliary cirrhosis, was applied using a newly developed computer program. The calculated risk scores were 4.91 for surviving patients compared to 7.65 for those who died (P less than 0.001). The survival probability at the end of the follow-up period was 88% vs 47% (P less than 0.001) for these two groups. In 12 patients of the total of 25, multiple values were calculated at yearly intervals. Usually these R values increased except in one patient with chronic active hepatitis treated effectively with corticosteroids, and for 2 others during the correction of vitamin K deficiency. Our data suggest that this model, originally designed for and validated in patients with primary biliary cirrhosis, may also be applied to predict survival in other non-alcohol-induced cirrhotics and therefore may be applicable in prospective controlled trials in cirrhotics or in evaluating the need for and the timing of liver transplantation in the (near) future in these patients.

Aged↗
PubMed1990

Campylobacter jejuni: clinical and diagnostic value of serum antibody titres.

Eighty patients with either bacteriologically confirmed Campylobacter jejuni infection and/or an antibody titre value of at least 1:80, determined by ELISA, were studied. A significant correlation was found between titre value and severity of symptoms (P = 0.015). Although a correlation was noted between symptoms score and endoscopic abnormalities, this was not quite statistically significant (P = 0.053). Comparison of patients with a titre of at least 1:1280 and those with lower titre values revealed a significantly higher symptom score (P = 0.019) and endoscopic score (P = 0.015) in patients with a higher antibody level. By using the previously recommended titre of 1:640 as a cut-off point for active infection, all significant differences were lost. Of 12 patients with positive stool culture, 7 had a titre value of at least 1:1280, suggesting a sensitivity of 58%. However, of 20 patients with negative culture, 4 showed this titre value, three of whom were studied several weeks after the onset of their illness. In those patients with clinically proven Campylobacter infection, the antibody response was characterized by a rapid initial rise and a slow four-fold drop in antibody titre after 3 to 5 months. Colonic involvement of the infection was seen in 63% of our patients with positive cultures. Our results support the conclusion that ELISA is a valuable method of diagnosing C. jejuni infections when stool cultures are likely to become negative, as is the case in prolonged complaints or complications after gastro-enteritis or in proctocolitis or after the use of antibiotics. Serial serum samples have no advantage over a single sample for antibody detection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Omeprazole (20 mg o.m.) versus ranitidine (150 mg b.d.) in duodenal ulcer healing and pain relief.

The object of this double-blind, multicentre study was to compare duodenal ulcer healing rates after 2 to 4 weeks of treatment with either 20 mg omeprazole o.m. or 150 mg ranitidine b.d. One hundred and eighty-one patients were randomized: 91 received omeprazole and 90 received ranitidine. In a per protocol analysis at 2 weeks, 63% of the patients were healed on omeprazole and 65% of the patients were healed on ranitidine (N.S.); at 4 weeks 91% were healed in the omeprazole group and 96% were healed in the ranitidine group. There were no differences in ulcer symptom relief between the two groups. There were no significant changes in laboratory values in either of the groups. Adverse events were few and mainly mild and transient. We conclude that both omeprazole (20 mg o.m.) and ranitidine (150 mg b.d.) result in rapid, ulcer healing rates.

Adult↗
PubMed1982

Clinical evaluation of the liver cell membrane autoantibody assay.

To evaluate the clinical significance of the liver cell membrane autoantibody (LMA) assay, we studied the presence, titre and immunoglobulin classes of LMA in 162 patients with various liver diseases and 156 controls. LMA was detected predominantly in patients with HBsAg-negative chronic active hepatitis (73% of 26 patients), but was also found in lower prevalences in other liver diseases, such as primary biliary cirrhosis syndrome (43% of 28 patients). LMA-positive primary biliary cirrhosis patients could be distinguished from LMA-positive patients with other liver diseases by the virtual absence of IgG class LMA. The LMA assay adds to the panel of assays for non-organ-specific autoantibodies in that it is more specific for autoimmune liver disease and in that it increases the diagnostic yield of autoantibody assays, e.g. in HBsAg-negative chronic active hepatitis from 77 to 92%. Immunosuppressive therapy status and biochemical parameters of disease activity, such as transaminase values, did not show a statistically significant relationship with the prevalence, the titre and the immunoglobulin class of LMA. It is concluded, that LMA is a sensitive and specific diagnostic marker for autoimmune liver disease.

Acute Disease↗
PubMed1979

Alcoholic hepatic disease. Specificity of IgA deposits in liver.

The extent to which the immunofluorescent phenomenon of homogeneous deposition of IgA in the hepatic sinusoids (so-called continuous pattern) was specific for alcoholic hepatic disease was investigated. In 66 of 320 liver biopsy specimens a continuous IgA pattern was observed. Alcoholism was mentioned in the cases of 50 of the 66 patients (76%). The biopsy specimens in the remaining 254 cases continued scanty detectable IgA (discontinuous pattern) or none. In the latter group only eight patients (3%) had histories of alcoholism. A direct correlation between a continuous IgA pattern in the hepatic sinusoids and alcohol abuse is thus inferred (P less than 0.001). Additional findings of the concomitant occurrence of IgA in the perisinusoidal linings of the liver, the wall of superficial cutaneous capillaries, capillaries of the gut, and the glomerular mesangium in association with alcoholic hepatic disease further substantiates the concept of the existence of an IgA-associated disease.

Antibody Specificity↗
PubMed1979

HLA and cell-mediated immunity in HBsAg negative chronic active hepatitis.

In 20 patients with severe HBsAg negative chronic active hepatitis a significant association has been found between the HLA determinants A1, B8, and Dw3 and cell-mediated immunity directed against human liver specific lipoprotein in vitro. This observation induces further speculation that genetic immunoregulatory action might be involved in the pathogenetic mechanisms of chronic active hepatitis in vivo.

Adult↗