Search PubMed⌕ Search

Biomedical subjects

I M Jacobson

Publications and source records attributed to I M Jacobson.

27 records · Page 2Linked to original sources
PubMed1985

Viral hepatitis vaccines.

Purified from the plasma of hepatitis B carriers, hepatitis B surface antigen particles have been used in a vaccine to prevent hepatitis B. This plasma-derived vaccine is immunogenic, protective, and has an excellent safety record. Indications and strategies for preexposure and postexposure prophylaxis are reviewed. In addition, novel approaches to hepatitis B vaccine development are being pursued and will provide the basis for the next generation of vaccines. Early progress has also been made toward a hepatitis A vaccine, but clinical availability is not imminent.

Adult↗
PubMed1985

Sulfasalazine-induced agranulocytosis.

We report a patient with ulcerative colitis in whom agranulocytosis was diagnosed 5 wk after the initiation of sulfasalazine therapy. Concomitant features included fever and skin rash, and bone marrow examination revealed severe myeloid hypoplasia. Antineutrophil antibodies were absent from the serum. Recovery began during the 2nd wk and was characterized by a leukemoid reaction with thrombocytosis. Subsequently, the patient received 5-aminosalicylate enemas without adverse effects. Agranulocytosis, a rare effect of sulfasalazine, appears to occur almost invariably during the first 2 months of therapy, and prompt evaluation is therefore required in patients with unexplained fever or other nonspecific illness during this period.

Agranulocytosis↗
PubMed1984

Epstein-Barr viral hepatitis: an unusual case and review of the literature.

We report a patient with icteric hepatitis and abdominal pain caused by Epstein-Barr virus in the absence of other common features of infectious mononucleosis. The peak alanine aminotransferase was 289 IU/I. Hemolytic anemia and urinary retention complicated the patient's course. Patients with infectious mononucleosis commonly have hepatic involvement but isolated symptomatic hepatitis is unusual. Although rare cases of liver failure have been reported, there is no evidence that Epstein Barr virus causes chronic liver disease. The clinical and histological features of Epstein Barr virus-induced hepatitis are reviewed.

Abdomen↗
PubMedDate not supplied

Epidemiology and clinical impact of hepatitis D virus (delta) infection.

We tested sera collected between 1976 and 1984 from 362 persons in a variety of epidemiologic categories with acute and chronic hepatitis B and from 76 hemophiliacs and drug addicts with hepatitis B antibodies for hepatitis D markers. Hepatitis D markers were common in hemophiliacs, drug addicts, Afghanistanis, prisoners and hemodialysis patients; rare in persons from other hepatitis-B endemic areas, persons with sporadic hepatitis B and homosexual men; and absent in health-care workers and institutionalized mentally retarded persons. No change was observed in the frequency of this infection during the 9 years of this study. We found hepatitis D markers in 5% of patients with acute hepatitis B, 1 of 3 with fulminant hepatitis and in 4 (1 in a homosexual male) of 12 episodes of acute hepatitis in hepatitis B carriers. Hepatitis D markers were more frequent in chronic liver disease (18%) than in asymptomatic hepatitis B carriage (2%), but there was no association between severity of chronic hepatitis and hepatitis D. These findings indicate that, to date, health-care workers and institutionalized mentally retarded persons have been spared from infection with this agent but suggest that homosexual males may not continue to be spared. Even in an area nonendemic for hepatitis D, this agent contributed to 20 to 30% of chronic hepatitis B and acute hepatitis superimposed on chronic hepatitis B infection.

Afghanistan↗
PubMedDate not supplied

Brush cytology evaluation of lesions encountered during ERCP.

Malignant obstruction of the pancreaticobiliary system is a frequent indication for ERCP. Twenty-five patients with abnormalities suggestive of malignancy were encountered during ERCP at our institution and brush cytology was obtained. Positive cytology specimens were collected in 12 of 20 (60%) cases of malignancy causing biliary obstruction. Using a recently developed cytology brush for the biliary tree, detection of malignancy in strictures of the bile duct had a sensitivity of 50% and a specificity of 100%. Both cases of cholangiocarcinoma were diagnosed with cytology, as were 5 of 10 cases of pancreatic cancer. It is concluded that brush cytology is a diagnostically reliable, highly specific technique for malignant lesions encountered at ERCP. In experienced hands, a positive cytologic result may obviate the need for additional invasive diagnostic studies.

Adenoma, Bile Duct↗
PubMedDate not supplied

Assessing health-related quality of life in chronic hepatitis C using the Sickness Impact Profile.

In a randomized, controlled trial that demonstrated the efficacy of interferon alfa-2b 3 million units three times a week for 24 weeks in controlling chronic hepatitic C (non-A, non-B), the Sickness Impact Profile (SIP) was used to evaluate the impact of disease and treatment on health-related quality of life (HRQOL). The SIP was self-administered by 160 patients before treatment, at the end of treatment, and at the study endpoint. Before treatment, patients with chronic hepatitis C scored significantly (P < 0.05) higher (worse) than an historical control group of the general population in mean total SIP score and in all categories except eating. The highest degree of impairment was observed in the work, sleep and rest, and recreation and pastimes categories. After treatment, patients who received interferon alfa-2b had significant (P < or = 0.05) improvement in work, sleep and rest, and recreation and pastimes scores. Numerical improvement was observed in total score, physical and psychosocial dimension scores, and most individual category scores. Mean SIP scores were unchanged or slightly worsened in untreated control patients. In responders (patients with improvement in serum alanine aminotransferase levels), the largest improvement was seen in work scores. The SIP appears to be a reliable and valid instrument for describing the impact of chronic hepatitis C on HRQOL but lacks disease-specificity and the ability to reflect clinically relevant changes. Thus the SIP is not the best instrument to evaluate the HRQOL effects of treatment with interferon alfa-2b in patients with chronic hepatitis C.

Activities of Daily Living↗