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Biomedical subjects

P J Grob

Publications and source records attributed to P J Grob.

At least 19 recordsLinked to original sources
PubMed1992

[Hepatitis and HIV infection in users of illegal drugs].

The prevalence of markers for ongoing or past infections with the hepatitis viruses A (HAV), B (HBV), D (HDV) and C (HCV) and with HIV are analyzed in i.v. drug users. The relevant serological parameters were measured in 1989, 1990 and 1991 in 220 to 380 sera each of drug users who frequented the open drugscene "Platzspitz" in a recreational area in the center of Zürich. The prevalence of viral markers for ongoing and past infections was many times higher in drug users than in the Swiss population. Over the three years the prevalence of HAV-markers rose from 50% to 72%, remained stable for HBV (52%, 57%, 58%) and most probably also for HCV. It slightly declined for HIV from 21% to 18% in one series and from 17% to 2% in another series. 10-34% of all individuals tested showed signs of at least one ongoing infection. Combined infections were frequently observed. The prevalence of viral markers was significantly dependent on the duration of drug use and if needle-sharing was practiced or not. Our data were analyzed in the context of the official notifications of these viral infections and related disorders to the Swiss Health Ministry. The risk of infections with the viruses analyzed here is 100-200 times higher in drug addicts than in the Swiss population. Drug users account for 42 to 52% of all infections (and clinical sequelae) notified in Switzerland. In the light of the fact that drug users also represent a potential source of spread of these viruses into the general population, the prevention effort in drug users should have first priority.

Adult↗
PubMed1992

[Hepatitis serology: use and interpretation].

Presently five viruses causing hepatitis are known, the hepatitis viruses A (HAV), B (HBV), C (HCV), D (HDV) and E (HEV). The genomic structure is known of most of all these viruses as well as some of their structural and regulatory gene products. Using radio- and enzyme immunoassays viral antigens can be detected for HBV and HDV as well as specific antibodies against all the five viruses. The results of these tests are the basis for the diagnosis and the follow-up of these infections but differ in their accuracy for each given virus. Concerning HIV one can differentiate between an ongoing or recently passed infection and immunity. Concerning HBV (and HDV), an ongoing infection at various stages can be distinguished from immunity. Such distinctions are not possible with respect to HCV except when also applying the expensive and cumbersome method of the polymerase chain reaction. In this paper the most important characteristics of the hepatitis viruses are given and the behaviour of the various viral markers during the infections and their consequences are described.

Epitopes↗
PubMed1991

[Antineutrophil cytoplasma antibodies (ANCA): clinical indications and experience with these new autoantibodies].

Antineutrophil cytoplasmatic autoantibodies (ANCA) have been tested in this laboratory for more than two years with a 3-fold increase in tests and positive results. The initial association with Wegener's granulomatosis has since been extended to microscopic polyarteritis and rapidly progressive glomerulonephritis. We review the published data. ANCA are not simply another laboratory test but have become an important tool for diagnosis, treatment monitoring and prevention of relapses in many vasculitis syndromes including some forms of rapidly progressive glomerulonephritis. The ANCA-associated antigens have been identified as a serin-proteinase and myeloperoxidase. This provides insights into the pathogenesis of the ANCA-related diseases.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1979

[Alpha fetoprotein and dysgerminaomas].

Sera of 128 consecutive patients in whom a malignant testicular tumor or an extragonadal teratoma was thought to be present were tested for alpha 1-fetoprotein (AFP). The AFP results were correlated with the final diagnoses. AFP was normal in all 9 patients with non-malignant testicular disorders and in all 29 patients with seminoma. AFP was elevated in 72% of the patients with non-seminomatous germ cell tumors when tested before treatment was started. At that time the degree of AFP elevation gave little information on the stage of the tumor. However, AFP concentrations reflected the disease course when tested repeatedly. Thus, regular AFP measurements may be of value in monitoring therapy in patients with non-seminomatous germ cell tumors.

Adolescent↗
PubMed1979

[Hepatitis virus B infection and hepatopathy after kidney transplantation].

Serological markers for hepatitis virus B (HBV) infection and the occurrence of hepatopathies were analyzed in 152 patients during the hemodialysis period and on average 3.8 years after receiving a renal allotransplant. At the beginning of hemodialysis, 25% of the patients showed signs of an ongoing or past infection with HBV (10% hepatitis virus B surface-antigen [HBsAG] positive and 15% anti-HBsAG positive). At the time of transplantation, 20% of the patients were positive for HBsAG and 25% had detectable anti-HBs. At the end of the study, 31% of the patients were positive for HBsAG and 25% had detectable anti-HBs. In 21 patients (14%) inflammatory liver disorders were observed: transitory hepatitis (7 patients), chronic persistent hepatitis (7 patients), chronic aggressive hepatitis (3 patients) and active cirrhosis (2 patients). Two patients had died in liver coma. All 21 patients with inflammatory hepatopathy had detectable HBsAG at the time of diagnosis, and all patients with chronic inflammatory liver disease were HBs carriers. In most of these patients the carrier state had been present for more than 3 years before diagnosis.

Carrier State↗
PubMed1979

[Severely increased alpha fetoprotein and associated diseases].

In 1977 and 1978 the serum concentration of alpha-1-fetoprotein (AFP) in 3200 patients was measured for diagnostic purposes. Values above 320 ng/ml were observed in 75 patients; they underwent closer study. The final diagnoses were hepatoma (50), germ cell tumors (15), other malignant tumors (6) and acute hepatitis (4). Also, chronic hepatitis and liver coma may be associated with AFP values above 320 ng/ml. Repeated measurements usually provide further diagnostic information.

Acute Disease↗
PubMed1979

[Systemic lupus erythematosus--clinical aspects and laboratory findings].

In a retrospective multicenter study 106 patients with systemic lupus erythematosis were analyzed who had had the disease for an average of 8.6 years, and from whom an average of 8 sera were tested within 3 years for current immunologic parameters. Cumulative clinical data showed arthropathies in 86% of the patients, exanthema (67%), cytopenia (58%), and involvement of the kidney (45%), lung (43%) and heart (24%). In at least 1 serum per patient the following immune abnormalities were found: antinuclear antibodies (98%), anti-native DNA (92%), low C3 (71%), low C4 (82%), circulated immunocomplexes (70%) and cold lymphocytotoxins (46%). A clinical score and an immunological score was introduced and the two items were compared: the immune data from a single serum do not provide long-range prognostic information. The present disease state is best reflected by the total immune score, C3 and C4 with, however, many exceptions. Within the disease course of some SLE patients, periods were observed during which no pathological immune serologic data are measureable. This phenomenon may pose diagnostic problems.

Antibodies, Antinuclear↗
PubMed1979

Immunodeficiency in epilepsy: a new view.

Up to 12% of epileptic patients have subnormal IgA serum concentrations. Previous observations suggest that IgA deficiency is correlated with hydantoin treatment and also with the type of seizure. In a followup study it is shown that IgA deficiency in epileptics is a rather constant feature of a given patient. The most pronounced changes in IgA levels were seen in patients in whom the hydantoin medication also changed. However, low IgA levels have also been reported in untreated epileptics. A new classification for the immunodeficiency state in epileptics is introduced.

Dysgammaglobulinemia↗
PubMed1979

[Viral hepatitis and dental practice].

A description of the clinical features and epidemiology of viral hepatitis is followed by a literature survey of the problems concerning the relevance of viral hepatitis to dental practice. Most investigators have found, that in comparison to the general population dentists do have an increased risk of viral hepatitis. The probability of acquiring hepatitis increases linearly with the duration of professional activity, it is highest in dental surgeons. A recent increase of the risks seems to be related to the growing problem of drug abuse and to the increasing carrier rate of hepatitis antigen in certain sections of the population. Isolated epidemics of viral hepatitis in patients of dentists who were hepatitis antigen positive have been described. Careful prospective studies suggest however, that overall hepatitis antigen positive dentists or physicians do not present a serious health hazard to their patients. The prophylactic measures useful in dental practice are discussed.

Carrier State↗
PubMed1978

[Severe alpha 1-antitrypsin deficiency: clinical observations of 21 patients].

The disease course is described in 21 patients with low serum concentrations of alpha1-antitrypsin of the phenotype Z (genotype pi ZZ). 13 of these patients have long-standing disease characterized by bronchitis or dyspnea beginning before the age of 40 and progressing to emphysema (11 patients) and to corpulmonale (7 patients). The remaining 8 patients are children with hepatopathy characterized by prolonged jaundice at birth, persistent hepatomegaly and persistently elevated liver enzymes. In 2 children, the evolution to cirrhosis was ascertained by biopsy.

Adolescent↗
PubMed1978

[Increase of unsaturated transcobalamine II in autoimmune diseases; effect of immunosuppressive therapy (proceedings)].

Transcobalamin II (TC II) is a serum protein responsible for transporting vitamin B12 to the cells. A previous observation of a child with congenital TC II deficiency and agammaglobulinemia suggested that this protein plays an important role in the immune response. Accordingly, TC II levels ere determined in 32 patients with autoimmune disease (AID) (i.e. 26 with lupus erythematosus, 4 with dermatomyositis, and 2 with autoimmune hemolytic anemia) and in 40 patients with acquired immunodeficiency due to chemotherapy. It was found that elevated TC II levels corresponded to active phases of AID. Changes in TC II levels correlated better with the clinical course of AID than complement, antinuclear antibody or native DNA binding capacity. This suggests that TC II could be a valuable parameter in following up activity of AID.

Autoimmune Diseases↗
PubMed1978

[Prenatal alpha fetoprotein screening for defects in the neural tube].

Abnormally increased alpha1-fetoprotein (AFP) in the serum of women in the 16th--18th week of pregnancy defines a group of individuals with a high risk for open neural tube defects (spina bifida and anencephaly). Repeated measurement of AFP, ultrasound and further clinical examination serve to exclude other situations associated with high serum AFP such as threatened or missed abortion, wrongly estimated duration of pregnancy, twins, etc. Suspicion of fetal neural tube defect can be substantiated by measurement of AFP in the amniotic fluid following amniocentesis to an extent which renders interruption of pregnancy justifiable. A symposium held in Zurich is reported whose purpose was to summarize the present state of knowledge and discuss the possibility of a screening program for Switzerland. It is estimated that in this country 0.8--1.3 cases of spina bifida and 0.1--1 case of anencephaly per 1000 births occur, rendering screening justifiable. The points which prompted most discussion were ethical questions. A Swiss study group was constituted for further evaluation of the matter.

Abortion, Spontaneous↗
PubMed1978

Increased unsaturated transcobalamin II in active autoimmune disease.

Measurements of transcobalamin II (T.C. II) concentrations in 26 patients with lupus erythematosus, 4 with dermatomyositis, 2 with autoimmune haemolytic anaemia, and in 40 immunosuppressed renal-transplant patients showed that T.C. II levels were raised during active phases of autoimmune disease. Changes in T.C. II levels correlated better with the clinical course of autoimmune disease than did changes in C3, the titre of antinuclear antibody, or native D.N.A.-binding capacity.

Anemia, Hemolytic, Autoimmune↗
PubMed1978

[Importance of thyroid diseases in internal medical hospital].

Retrospective analysis of 2627 and prospective analysis of 289 inpatients (mean age: 57 years) of the Department of Internal Medicine, University of Berne, disclosed euthyroid goiter in 33.9%. 65% of the patients had urinary iodine excretion below 100 microgram per gram creatinine. Thus, iodination of salt (raised to 10 mg potassium iodide per kg in 1962) is still inadequate. 1.4% of the inpatients had hyperthyroidism. Hypothyroidism was diagnosed in 0.5% of the inpatients, which is about three times less than in comparable prospective English studies. The finding raises the possibility that cases of hypothyroidism have been frequently missed. Antibodies against thyroglobulin and/or microsomal antigen were present in 8.5% of 105 goiter patients and 4.0% of 124 patients without goiter. This is a definitely lower incidence than has been reported in comparable English populations and confirms reports from other Alpine endemic goiter areas. Among the 2916 patients of the entire study only 3 cases (0.1%) of clear-cut chronic lymphocytic (Hashimoto) thyroiditis were found.

Autoantibodies↗
PubMed1978

Immunoglobulin abnormalities in relatives of IgA deficient epileptics.

Serum levels of IgA were found to be reduced in some patients with epilepsy. Further studies revealed that only epileptics with constitutional factors for seizures showed, if ever, IgA deficiency, particularly those treated with hydantoins (up to 25%). In order further to substantiate the association of immunoglobulin alterations with epilepsy nine families in whom the disease was clustered were investigated. An IgA deficiency was detected in 16 of the 19 epileptics (three without hydantoin medication), but in none of their 45 non-epileptic relatives. However, four of the relatives had a low IgM. Seven other families were tested in each of which only one IgA deficient epileptic was known. No other family members were found with a low IgA, but 24 of 58 such relatives had increased IgM serum concentrations. The association of IgA deficiency and epilepsy with IgM imbalances in relatives of IgA deficient epileptics gives additional support for the hypothesis that immune imbalances and certain forms of epilepsy might be linked.

Epilepsy↗
PubMed1977

[Transfer factor therapy in a patient with anergic pulmonary tuberculosis].

Report on a patient suffering from severe, relapsing pulmonary tuberculosis showing progressive clinical deterioration accompanied by the appearance of cutaneous anergy to tuberculin. In addition, the sputum cultures showed growth of Mycobacterium intracellulare. During therapy with transferfactorZurich there was a slow but impressive clinical improvement, the skin reactivity to tuberculin was reconstitued and the sputum cultures became negative. The radiological findings remained unchanged.

Adult↗
PubMed1977

[Determination of carcinoembryonic antigen in medical practice].

108 determinations of CEA plasma concentrations were ordered for diagnostic purposes by the medical staff of our clinic between January 1974 and April 1976. Its usefulness was retrospectively analyzed by comparing the initially suspected diagnosis serving as the rationale for CEA determination with the CEA plasma levels and the final diagnoses of the patients when leaving the hospital. Of 32 patients with proven malignancies of various types the CEA concentrations were normal in 10, slightly elevated (2.5-20.0 ng) in 15, and highly elevated in 7, all having metastatic tumors. However, in 35 of the remaining 67 tested individuals without detectable malignancies the CEA concentrations were also slightly elevated (2.5-20.0 ng); these patients either had acute infections (10 individuals), autoimmune disease disorders (1 individual), various other nonmalignant diseases (10 individuals), or were heavy smokers. In 98 of 108 patients CEA testing had been ordered either to confirm or to rule out a suspected malignancy. The results were most often of little help. Malignancies were found in 15 of 50 patients with elevated CEA, but also in 9 of 48 patients with normal values. In only 6 patients did the CEA results influence further diagnostic and/or therapeutic measures, which consequently did not always prove to be beneficial for the patient.

Carcinoembryonic Antigen↗