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Biomedical subjects

J Heathcote

Publications and source records attributed to J Heathcote.

At least 73 records · Page 4Linked to original sources
PubMed1987

The hepatitis B carrier state--a follow-up study of 100 consecutive cases.

The clinical, demographic, serologic, and histopathologic features of 100 consecutive patients with chronic hepatitis B were studied. The subjects were from diverse racial backgrounds; 59 had emigrated to Canada from geographical areas with high hepatitis B carrier rates. A reduced 5-year survival rate was seen only in those with cirrhosis; death was most commonly related to sepsis. The male to female ratio was 4.0 in the total study group but was higher in those with elevated transaminases (6.0 vs 2.0, p less than 0.05). Those patients with mild-to-heavy alcohol consumption were more likely to have elevated transaminase values than those who drank no alcohol (p less than 0.05). The mean annual sero-conversion rate from HBeAg to Anti-HBe was 8.0%. The HBeAg status did not correlate with the presence of histologic activity or fibrosis.

Adolescent↗
PubMed1986

Arthritis, vasculitis, and cryoglobulinemia associated with relapsing hepatitis A virus infection.

Hepatitis A virus, unlike hepatitis B virus, has rarely been associated with extrahepatic features. Two patients developed relapsing hepatitis A complicated by arthritis in both cases and cutaneous vasculitis in one. Both patients had cryoglobulinemia, with cryocrit values of 4.3% and 8.6%. Serologic studies showed that the cryoglobulin consisted of polyclonal IgM and IgG. The washed cryoglobulin was analyzed by sucrose density gradient ultracentrifugation under neutral (pH 7.4) and acidic (pH 2.8) conditions. Enzyme-linked immunosorbent assay techniques were used to characterize the native and dissociated cryoglobulin. The cryoglobulin contained acid-dissociable IgG complexes greater than 19S, and high molecular weight rheumatoid factors of both IgG and IgM isotypes that could be dissociated to 7S and 19S forms, respectively. Dissociation of the cryoglobulin augmented 7S anti-hepatitis A virus IgG 2.27-fold, but augmented total 7S IgG only 1.12-fold, suggesting enrichment of antiviral antibody in the cryoglobulin.

Adult↗
PubMed1982

Sulindac hepatotoxicity.

Two patients who developed painless jaundice while taking sulindac are described. Rechallenge in one case confirmed the association of hepatic damage with sulindac administration. Laboratory data and liver biopsy findings suggested a hepatitis with cholestatic features.

Aged↗
PubMed1981

Immunity and nutrition in heroin addicts.

An immunological and nutritional survey was conducted on 16 heroin addicts and 16 control subjects matched for age and sex. Skin testing showed none of the addicts to be anergic. Three of four individuals who had positive purified protein derivative (PPD) skin tests failed to produce leucocyte migration inhibition factor (LMIF) to PPD in vitro; in contrast, four of five PPD skin test positive controls produced LMIF. A relative lymphocytosis was found in the heroin addicts although the percentage of 'T' lymphocytes (E-rosetting techniques) was similar to that of the control population. A significant elevation of serum IgG and IgM (p less than 0.0005) was present. Although none of the addicts studied were nutritionally deficient, the serum vitamin C, B6 and albumin levels were significantly lower than in the controls. Elevation of serum aminotransferase values occurred in half the patients, but there was no correlation with presence of serum markers of hepatitis B infection or absent LMIF production. The results suggest that heroin addicts are capable of responding to antigens when their nutritional status in normal, despite the presence of liver enzyme abnormalities.

Adult↗
PubMed1980

Perforation of an adenocarcinoma of the small bowel affected by regional enteritis.

This report is of a patient with long-term small bowel regional enteritis who presented with a perforation of an adenocarcinoma involving a diseased portion of ileum. Adenocarcinoma of the small bowel is rare. The incidence of small bowel adenocarcinoma may be higher in patients with regional enteritis, but a definite relationship cannot be established on the basis of data presently available. Small bowel adenocarcinoma in regional enteritis usually presents with obstructive symptoms.

Adenocarcinoma↗
PubMed1979

Chronic persistent hepatitis: hepatitis B virus markers and histological follow-up.

Twenty-six untreated patients with chronic persistent hepatitis were followed prospectively for one to 17 years (mean 5.6 years). The patients developed no clinical features of chronic liver disease. Raised serum transaminase levels were usually, but not consistently, the only biochemical abnormality; gamma globulin values were normal. Serum markers of past or present hepatitis B infection were found initially in 14 patients: another two developed markers during their follow-up. Nine patients progressed to a mild or moderate chronic active hepatitis as shown by serial needle liver biopsies but there was no evidence of cirrhosis. This progression was not associated with any clinical or biochemical deterioration. Seven of these patients had presented with insidious symptoms, seven had serum markers of hepatitis B infection, and the four who were HBsAg positive had relatively lower serum HBsAg concentrations than did those patients who continued with chronic persistent hepatitis.

Adult↗
PubMed1977

Detection, by three techniques, of hepatitis B surface antigen (HBsAg) and determination of HBsAg and anti-HBs titres in patients with chronic liver disease.

The sensitivities of three technqiues used to detect serum hepatitis B surface antigen (HBsAg) were compared in 411 patients with various types of chronic liver disease. Counterimmunoelectrophoresis proved an unreliable test. Two haemagglutination technqiues were slightly less sensitive than radioimmunoassay but were more rapidly performed. Less sensitive techniques were particularly unreliable in active liver disease where HBsAg titres were low. HBsAg was detected in patients with chronic persistent hepatitis, alcoholic liver disease, chronic active liver disease with or without cirrhosis, and primary liver cell carcinoma. Forty-six of the 68 (68%) HBsAg positive subjects were males coming from outside the United Kingdom. The HBsAg titres in 13 subjects with chronic persistent hepatitis were significantly higher (P less than 0-001) than those in 43 subjects with chronic active liver disease. Corticosteroid therapy did not alter the HBsAg titre significantly. None of the 28 HBsAg positive subjects studied serially for up to two years cleared HBsAg from the serum. Anti-HBs was examined by passive haemagglutination and found in 35 subjects, 26 of whom had no evidence of liver disease, 80% came from abroad. Anti-HBs was believed to be of epidemiological rather than of pathological importance.

Antibodies↗
PubMed1977

Serum alpha-fetoprotein levels in patients with acute and chronic liver disease. Relation to hepatocellular regeneration and development of primary liver cell carcinoma.

Using a radioimmunoassay technique serum alpha-fetoprotein could be detected in healthy adults in concentrations of less than 20 microgram/l. Of patients with acute, viral hepatitis 43% exhibited a transient rise of serum alpha-fetoprotein, the peak occurring eight to nine days after the maximum recorded serum aspartate transaminase activity. Patients with hepatic damage due to paracetamol poisoning were also shown to have transiently raised levels, the peak occurring earlier than in subjects with viral hepatitis. Six subjects with fatal fulminant hepatitis were studied; the three with the more protracted illness were noted to have increased levels before death. Twenty of 163 cases of chronic liver disease also had raised serum alpha-fetoprotein concentrations. In four, primary liver cell cancer developed; in two of these the serum alpha-fetoprotein levels rose progressively, and in two it remained raised but at low levels.

Acetaminophen↗
PubMed1976

Intrahepatic cholestasis in childhood.

The apparent well-being of some children who as neonates were believed to have obstructive jaundice prompted us to study the clinical course, histologic features and possible etiologic factors in 17 children with cholestasis in the neonatal period. During a follow-up period of five months to 22 years, all had signs of chronic cholestasis, but only four died (two from nonhepatic causes); the others live remarkably normal lives. Serial hepatic biopsies in 11 showed a variety of initial lesions, which progressed to hypoplasia of the intrahepatic bile ducts, increasing portal fibrosis and eventual cirrhosis. Although evidence of possible viral infection was found in only 10 cases, a hepatitis, beginning either before or after birth, appears to be a likely original cause. The histologic changes seen may represent different stages of one process, starting as cholestasis with or without evidence of hepatitis and progressing to obliteration or failure of normal growth of the intrahepatic bile ducts.

Adolescent↗
PubMed1976

A prospective controlled trial of azathioprine in primary biliary cirrhosis.

Between 1968 and 1974, azathioprine has been used in a controlled prospective trial to treat patients with symptomatic but precirrhotic primary cirrhosis. Forty-five patients were admitted, of whom 22 were given azathioprine in a dose of 2 mg per kg of body weight. During the 1st year, serum aspartate transaminase levels showed a significant change in favor of the treated group, but improvement did not continue. Throughout the trial, serum alkaline phosphatase, bilirubin, cholesterol, albumin and immunoglobulin M values showed no significant change. Titers of serum mitochondrial antibodies tended to become negative more often in the treated than the untreated. Pruritus cannot be assessed objectively, but seemed less in the treated than in controls. Serial hepatic biopsy specimens showed the development of cirrhosis equally in the two groups. Survival, as judged by the life table method, was similar for the first 5 years of the trial. There was, however, a significant difference in favor of the treated group in the 6th year, although the number of patients available for assessment at that time was extremely small.

Azathioprine↗
PubMed1975

Incidence and clinical significance of e antigen and antibody in acute and chronic liver disease.

"e" is a serum antigen associated with type-B hepatitis. It is found only in hepatitis B surface antigen (HBsAg) positive sera, but is antigenically distinct from HBsAg. e antigen was not detected in the serum of any of 99 cases of acute type-B hepatitis who recovered normally. Its antibody, anti-e, was found in 14 (14%). The antibody usually appeared before clearance of HBsAg and before appearance of HBsAb. Serum e was not detected in any of 29 symptom-free carriers of HBsAg, but 21 (73%) showed anti-e. Serum e was found in chronic active hepatitis (44%) and chronic persistent hepatitis (31%). The antibody, however, was detected in only 2 of 79 patients with chronic active hepatitis but in 7 (44%) of chronic persistent hepatitis. Serum e was not found in 5 patients with primary liver-cell carcinoma or 5 with inactive HBsAg-positive cirrhosis. The antibody was, however, found in all 5 of those with inactive cirrhosis and in 4 of the 5 with primary cancer. These results suggest that the presence of e antigen is associated with active and usually continuing liver disease. Anti-e, however, is associated with inactive liver disease and asymptomatic carriage of HBsAg, and its presence must be regarded as a valuable sign in predicting those who will escape progressive chronic liver disease.

Acute Disease↗
PubMed1974

The epidemiological importance of 'ay' and 'ad' subtypes of the HB-Ag.

The distribution of the subtypes ;ay' and ;ad' has been assessed in 159 hepatitis B antigen (HB-Ag) positive subjects with a variety of associated hepatic conditions. A specific subtype could not be correlated with any particular hepatic pathology when the whole group was considered. However, the distribution of these two subtypes did vary according to the geographical origin of the subject or infection, or the presumed route of infection, so that there was an apparent association of one subtype with a certain disease state. Subtyping performed on 10 HB-Ag-positive households showed the subtype to be the same within nine, emphasizing the epidemiological rather than the pathological importance of the ;ay' and ;ad' subtypes of the HB-Ag.

Carrier State↗