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Biomedical subjects

O Weiland

Publications and source records attributed to O Weiland.

At least 127 records · Page 7Linked to original sources
PubMed1988

Long-term follow-up of chronic post-transfusion non-A, non-B hepatitis: clinical and histological outcome.

A chart review of chronic hepatitis cases at the Department of Infectious Diseases, Roslagstull Hospital, Karolinska Institute, Stockholm, Sweden, revealed 37 patients with chronic non-A, non-B hepatitis, caused by blood transfusions or intravenous gammaglobulin infusions. They had been followed up long-term, mean 46 months (range 10-149). During the initial hepatitis episode most patients had been anicteric and 13/37 (35%) asymptomatic. Yet, the majority developed progressive liver disease with chronic active hepatitis, with or without histological signs of cirrhosis. Thus, 10/18 (56%) on whom a liver biopsy had been performed within 7-12 months had chronic active hepatitis, four (22%) with histological signs of cirrhosis, and of the five patients biopsied after greater than or equal to 5 years of follow-up, three (60%) had histological signs of cirrhosis. Accordingly, as the duration of follow-up increases, an increasing number of patients with post-transfusion non-A, non-B hepatitis seem to develop cirrhosis.

Biopsy↗
PubMed1988

Chronic active hepatitis in Sweden. The etiologic spectrum, clinical presentation, and laboratory profile.

An epidemiologic study covering about 1/3 of the adult Swedish population showed an annual incidence of chronic active hepatitis (CAH) of 1.6 per 100,000. At least 45% had a viral cause of their CAH, the proportion being distinctly higher in large cities than in rural ones. Drugs, alcohol, and metabolic disorders were rarely identified as etiologic factors. The prevalence of ulcerative colitis and gluten enteropathy was remarkably high in idiopathic CAH. Compared with antibody-negative patients with idiopathic CAH, antibody-positive patients showed higher rates of the female sex, IgG increase, anti-HBs negativity, compliance with the Mayo criteria for treatment, and absence of previous episode of jaundice. Furthermore, in autoantibody-negative idiopathic CAH the prevalence of anti-HBs antibodies was at least three times greater than in the Swedish population, suggesting a viral cause of some forms of idiopathic CAH, a suggestion supported by the clinical pattern of the disease.

Adult↗
PubMed1988

Alpha interferon treatment of chronic non-A, non-B hepatitis caused by intravenous gammaglobulin.

Two patients with hypogammaglobulinemia and chronic active non-A, non-B hepatitis caused by intravenous gammaglobulin substitution were treated long-term with alpha-2b interferon (Introna). Both achieved normal aminotransferase levels within 2-12 weeks after initiation of interferon therapy. One patient was rebiopsied after 6 months of therapy and showed some degree of improvement in the liver inflammatory activity. The beneficial effects warrant a randomized controlled study.

Aged↗
PubMed1988

Non-A, non-B hepatitis after open-heart surgery in Stockholm: declining incidence after introduction of restrictions for blood donations due to the human immunodeficiency virus.

In 1979 the incidence of non-A, non-B (NANB) posttransfusion hepatitis (PTH) in Stockholm was 19%. After the discovery of HIV the Swedish Board of Health put forward new regulations for blood donations and since 1985 has enforced testing for HIV on all blood units. To find out if these measures have had any impact on the incidence of NANB PTH, 316 patients transfused during open-heart surgery from December 1985 to November 1986 were followed prospectively. PTH due to the NANB agent(s) developed in 4.4% (14/316). A significantly higher mean number of blood units had been given to patients undergoing coronary artery bypass surgery in whom NANB PTH developed than in those who did not develop the infection. The mean number of blood units transfused during open-heart surgery in Stockholm had decreased from 16 in 1979 to 10 in 1985-1986. The number of NANB PTH cases/1,000 blood units transfused declined from 12 to 4 during the same period. Thus, both the reduced number of blood units given during open-heart surgery and the new restrictions for blood donors seem to have been effective in reducing the risk for NANB PTH in Stockholm during the 1980s.

Adult↗
PubMed1987

Evaluation of an oral bile acid loading test for assessment of liver function in chronic hepatitis. A comparison with fasting serum bile acids and i.v. galactose elimination test.

In 40 patients with histologically verified chronic hepatitis, (chronic persistent hepatitis, n = 13; chronic active hepatitis without, n = 14; or with cirrhosis, n = 13), of viral and autoimmune origin, serum bile acids (SBA) were measured before and during 3 h after oral ingestion of 1 g chenodeoxycholic acid (CDA). Fasting SBA were elevated in 22 (55%) patients, whereas the CDA loading test was abnormal in 15 (38%) patients and the galactose elimination was prolonged in 16 (40%) patients. In patients with chronic active hepatitis, 20/27 had elevated SBA either in the fasting state (18/27) or after the CDA loading test (13/27). Normal SBA values were found in 9/13 (70%) patients with chronic persistent hepatitis. Thus, fasting SBA is not sensitive enough to detect mild chronic inflammatory liver disease as chronic persistent hepatitis, but seems to be as sensitive as the galactose elimination or CDA loading tests in detecting potential severe liver disease. Fasting SBA may thus be used as a complement of conventional liver tests in the follow-up of chronic hepatitis as assessment of liver function. An oral CDA loading and an i.v. galactose elimination test add no further information to that given by fasting serum bile acids.

Adult↗
PubMed1986

Epstein-Barr virus (EBV) antigen-specific leukocyte migration inhibition (LMI) in infectious mononucleosis (IM). I. Kinetics and response to a membrane protein on EBV-transformed cells.

Cell-mediated immune response of mononucleosis (IM) patients to Epstein-Barr virus (EBV)-determined antigens was measured by the leukocyte migration inhibition (LMI) assay. Patients in the acute phase of the disease failed to respond to partially purified nuclear antigen, EBNA, or to cell extracts that contained EBNA as the predominant EBV antigen. They showed a strong specific response to cell extracts enriched in early antigen (EA) and virus capsid antigen (VCA). The LMI response to EBNA appeared in convalescence in parallel with EBNA-specific antibodies, slightly later in children than in adults. Membrane fractions of EBV-carrying, virus nonproducer Raji cells induced an EBV-specific LMI at approximately the same time. A bacterial fusion protein containing the hydrophilic part of the virus-coded membrane antigen of latently EBV-infected cells also induced an EBV-specific response that parallelled the LMI reaction elicited by the Raji membrane fraction. This is in line with our previous finding (D. Sulitzeanu et al., J. Virol. 58, 230, 1986) that this fusion protein shares an epitope with Raji cell membranes.

Adolescent↗
PubMed1986

Long-term follow-up of 60 patients with chronic hepatitis B. I. Seroconversion in the hepatitis B e-system, frequency of delta infection and histological outcome.

Sixty patients with liver biopsy documented chronic hepatitis B attending Roslagstull Hospital for Infectious Diseases, Stockholm, Sweden, were followed during a mean period of 53 months (range 7-133 months) in order to evaluate the frequency of delta infection and HBeAg seroconversion as well as the histological outcome as assessed by liver biopsy. Spontaneous HBeAg clearance and development of anti-HBe occurred among 17 of 36 initially HBeAg positive patients (47%), corresponding to an annual seroconversion rate of 11%. Biochemical improvement was noted in 7/17 patients (41%) after seroconversion as against in 2/19 patients (10.5%) with HBeAg persistence. Superinfection with the delta agent was seen to be associated with severe liver injury among drug addicts and immigrants with chronic hepatitis B. In the absence of a delta infection, progressive liver disease seemed to be associated with persistence of HBeAg. Although none of the homosexual men studied were delta superinfected, 71% developed chronic active hepatitis (CAH) with or without cirrhosis (CI).

Adolescent↗
PubMed1986

Long-term follow-up of 60 patients with chronic hepatitis B. II. Hepatitis B virus DNA in serum correlated to the hepatitis Be-system and presence of delta superinfection.

Forty-six patients with liver biopsy-documented chronic hepatitis B were followed for a mean period of 44 months. A total of 200 serum samples from these patients was analyzed for the presence of hepatitis B virus DNA (HBV-DNA). The results were correlated to the HBeAg/anti-HBe status and to the presence of anti-delta as a marker for delta superinfection. In the initial serum samples HBV-DNA was detected in the vast majority of the patients independent of the HBeAg/anti-HBe results and whether the patients were superinfected by delta agent or not. During the complete follow-up period, HBV-DNA was detected in 88% of those patients who were positive for HBeAg, irrespective of the presence or absence of a simultaneous delta infection. When anti-HBe positive, 79% of the patients with anti-delta had detectable HBV-DNA in their sera, while only 43% of those negative for anti-delta were positive for HBV-DNA. The results indicate a high prevalence of virus release into the blood of patients with chronic hepatitis B, especially among patients positive for HBeAg and among those anti-HBe positive patients who have a delta superinfection.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Yersinia enterocolitica septicemia: clinical and microbiological aspects.

Septicemia is a rare but serious complication of infection with Yersinia enterocolitica (Y.e.). Seven cases of Y.e. septicemia are presented. Five of the patients had no underlying disease predisposing to septicemia. Five patients displayed recurrent episodes of septicemia, despite treatment with recommended doses of antibiotics to which the isolates were sensitive in vitro. One patient developed endocarditis which required surgical replacement of the aortic valve. Other clinical manifestations were arthritis, diverticulitis and pulmonary abscesses. The outcome was fatal to 3 elderly patients. The serological response to Y.e. was followed by tube agglutination and a diffusion-in-gel enzyme-linked immunosorbent assay. One patient, with a benign course of illness, had transient elevated Y.e. antibody titres, while the 3 cases with a protracted disease showed sustained antibody responses for 6-18 months. Blood isolates of Y.e. had ordinary virulence characteristics identical to fecal isolates and produced extracellular beta-lactamase. All isolates were sensitive in vitro to trimethoprim-sulfamethoxazole, mecillinam, piperacillin, cefotaxime, ceftazidime, chloramphenicol and gentamicin. The lowest MIC values were recorded for mecillinam. Full synergistic activity was demonstrated when mecillinam was combined with trimethoprim-sulfamethoxazole, cefuroxime or rifampicin.

Aged↗
PubMed1984

Virologic, immunologic, and clinical observations on a patient during the incubation, acute, and convalescent phases of infectious mononucleosis.

One patient with infectious mononucleosis (IM) was studied from the probable time of Epstein-Barr virus (EBV) infection (38 days before the onset of clinically overt disease), during the incubation and acute phases, until 6 months after clinical remission. Analysis of spontaneous outgrowth of EBV-carrying lymphoblastoid cells, by limiting dilution on feeder layer cultures, showed that virus containing B lymphocytes are already present early during the incubation period. Also low interferon serum levels were detected early after infection, and only before the onset of clinical disease. All other studied clinical laboratory and virus-associated variables were within normal range during the incubation phase, but changed to a pattern characteristic of IM in parallel to the clinical symptoms. During the acute disease EBV-associated nuclear antigen (EBNA)-positive cells could be directly detected among the lymphocytes, and antibodies to EBV antigens appeared. Lymphocytes stained by monoclonal antibodies, detecting Ia-like determinants (activated cells) and suppressor cells, increased dramatically, in parallel to a strong increase of functional suppressor cell activity, measured by inhibition of blastogenesis and PWM-induced immunoglobulin production. During the acute phase there was also a decrease of spontaneous cytotoxicity against the NK-sensitive cell line K562, while cytotoxicity (spontaneous) against an autologous EBV-positive lymphoblastoid cell line (LCL) was detected only during this phase. These reactions correlated to the presence of blasts, and the autologous reaction was exerted mainly by Fc-receptor-negative cells. Lymphokine production in response to EBV antigens was also initiated during the acute phase. During the convalescence period the serological and cellular immune parameters adjusted to the pattern of a normal EBV-seropositive person.

Adolescent↗
PubMed1983

Ceftazidime in septicaemia.

Thirty-five patients with mean age 70 years (range 22 to 92) with 37 proven episodes of septicaemia (26) or bacteraemia (11) were treated with a mean ceftazidime dose of 1.80 (range 1 to 2 g) bid for 12 (range 3 to 17) days. Twenty patients had underlying diseases. Escherichia coli was the most common pathogen (19/37). Of the 37 strains 36 were tested for antibiotic sensitivity and 35 were fully sensitive with MIC less than or equal to 8 mg/l (21 less than or equal to 0.12 mg/l). The remaining strain, a Staphylococcus aureus, was moderately susceptible (MIC 16 mg/l). Thirty patients (81%) were cured, six improved and one considered not evaluable. Serum concentrations were studied in 12 patients with slightly or moderately impaired renal function. They had trough and peak values ranging from less than or equal to 1.0 to 118.4 mg/l and 30 to 246.4 mg/l, respectively. In three patients the initial dose of 2 g bid had to be reduced to 1 g bid due to very high trough levels, and due to low peak value in one patient the dose was increased from 1 g to 2 g bid. Adverse reactions were mostly mild (positive Coombs' reaction, transiently raised aminotransferases or raised serum creatinine). Treatment had to be stopped in two cases due to drug fever and/or rash. Therapy with ceftazidime 2 g bid seems to be successful in Gram-negative septicaemia; however, in patients with decreased renal function serum concentrations should be determined.

Adult↗