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Biomedical subjects

R E Sampliner

Publications and source records attributed to R E Sampliner.

At least 145 records · Page 8Linked to original sources
PubMed1986

Efficacy of radiologic studies in the detection of Barrett's esophagus.

Esophageal radiography using two different air-contrast techniques was used to examine 30 patients with Barrett's esophagus and 18 controls. All patients had upper gastrointestinal endoscopy and biopsy of the esophagus. The radiographs were randomized, masked, and then interpreted by two radiologists blinded to the endoscopic and biopsy diagnosis. Depending upon the diagnostic strategy of the radiologist, sensitivity varied from 0.36 to 0.83 and specificity from 0.56 to 1.00. A typical receiver-operating-characteristic curve was generated. Esophageal radiography is effective in identifying those patients who have stricture and ulceration as a complication beyond the epithelial transformation. However, because of low sensitivity, it is not a satisfactory method for identifying most cases of Barrett's esophagus.

Adult↗
PubMed1986

Colorectal neoplasms and Barrett's esophagus.

Prospective colonoscopic study of 36 patients with Barrett's esophagus found colorectal adenomas in 33% of patients. Of patients aged less than 60, four of 17 (24%) had adenomas, while patients aged 60 or more had adenomas in eight of 19 (42%) cases. All adenomas were less than or equal to 10 mm diameter. No colorectal malignancies were found in these patients. This prevalence of neoplasms is consistent with results of autopsy studies. It is concluded that no increased risk of colorectal neoplasms was found in this group of patients with Barrett's esophagus.

Adenoma↗
PubMed1985

Severe pulmonary hypertension in a patient with Whipple's disease.

Rapidly progressive heart failure, in part related to severe pulmonary hypertension, developed in a patient with biopsy-proved Whipple's disease. The patient's pulmonary hypertension progressed despite antibiotic therapy and histologic remission of his intestinal disease. The combination of oral nifedipine and low-flow continuous oxygen led to both short- and long-term increases of at least 2 liters per minute in cardiac output and reductions of more than 10 mm Hg in mean pulmonary artery pressure. Accompanying these hemodynamic changes was an improvement of more than 10 percent in right ventricular ejection fraction. The relationship between this patient's pulmonary hypertension and his Whipple's disease is not known.

Drug Combinations↗
PubMed1985

The yield of diagnostic upper endoscopy: results of a prospective audit.

Because of its widespread availability and the generally increasing economic pressure, endoscopy needs critical scrutiny to establish appropriate clinical guidelines. We carried out a prospective evaluation of 200 consecutive upper gastrointestinal (GI) endoscopies to ascertain the frequency of abnormal findings when specific indications were the impetus to endoscopy. Those indications were esophageal complaints, upper GI bleeding, abdominal discomfort, known premalignant disorders and abnormal findings on barium meal. The overall frequency of abnormal findings for all indications was 66%. Abnormal endoscopic findings were most often present when upper GI bleeding or premalignant conditions (88 and 87%, respectively) were reasons for endoscopy. Endoscopic confirmation of lesions seen on barium meal was 64%. Only 37% of patients endoscoped for abdominal discomfort had abnormal findings. Moreover, as symptoms resolved in 70% of such patients within 1 to 9 weeks, the low yield of endoscopy suggests that our current threshold for endoscopy in this setting may be too low. Refinement of the indications for and reassessment of the timing of endoscopy are needed.

Abdomen↗
PubMed1984

Community-acquired non-A, non-B hepatitis: clinical characteristics and chronicity.

The characteristics of 86 patients with acute non-A, non-B hepatitis were compared to 23 patients with acute hepatitis A and 76 with acute hepatitis B by medical record reviews of patients seen at 5 hospitals in Baltimore, Maryland, as part of case-control study of viral hepatitis. Results of serum aminotransferase levels, bilirubin, albumin, and prothrombin times alone could not distinguish the type of viral hepatitis because of extensive overlap. The alanine aminotransferase range for non-A, non-B hepatitis was 56 to 1819 IU/liters, for hepatitis A 250 to 1995 IU/liters, and for hepatitis B 203 to 2120 IU/liters. The ranges of aspartate aminotransferase and bilirubin for the types of hepatitis also overlapped. Fewer patients with non-A, non-B hepatitis or hepatitis A had a prolonged prothrombin time compared to patients with hepatitis B. Hepatic encephalopathy was seen only in two patients with hepatitis B. Forty-two percent of non-A, non-B hepatitis patients followed for 6 months or longer continued to have elevated alanine aminotransferase levels. Chronic alanine aminotransferase elevation was independent of the source of infection: transfusion, parenteral drug use, or all other sources. Prolonged follow-up is necessary to evaluate chronicity in patients with non-A, non-B hepatitis.

Alanine Transaminase↗
PubMed1984

Predominance of immunoglobulin M antibody to hepatitis B core antigen in chronic carriers of hepatitis B surface antigen.

IgM predominance of antibody to hepatitis B core antigen (anti-HBc) was determined by a modification of a commercial competitive binding radioimmunoassay in 190 chronic carriers of the hepatitis B surface antigen; 16.8% of the chronic carriers had IgM predominance. The carriers with IgM predominance of anti-HBc were more likely to have elevated aminotransferase levels (25% vs. 11%) and chronic active hepatitis by liver biopsy (4 of 7 vs. 2 of 20) than carriers with IgG predominance. IgM predominance of anti-HBc may be an indication of more severe liver involvement in chronic hepatitis B infection.

Adult↗
PubMed1982

Sporadic non-A, non-B hepatitis: frequency and epidemiology in an urban U.S. population.

Patients with acute viral hepatitis were identified at five hospitals in Baltimore, Maryland between February 1979-August 1980. Of the 295 patients with serologically diagnosed hepatitis, 42% had non-A, non-B hepatitis; 48% had hepatitis B; and 10% had hepatitis A. Compared with matched control patients with no liver disease, patients with non-A, non-B hepatitis more often had received a blood transfusion (11% vs. O, P less than 0.001), used parenteral drugs (42% vs. 4%, P less than 0.001), were employed as health workers in direct patient care or hospital laboratory work (6% vs. 3%, P less than 0.05), had personal contact with others who had hepatitis (16% vs. 1%, P less than 0.001), or had ingested raw shellfish (34% vs. 20%, P less than 0.01). A history of previous clinical hepatitis and serologic markers indicating previous hepatitis B infection were found in patients with non-A, non-B hepatitis more often than in the control patients. Chronic non-A, non-B hepatitis was found in 34 (42.5%) of 80 patients with non-A, non-B hepatitis.

Adolescent↗
PubMed1981

Intrafamilial cluster of hepatitis B virus infection: study of a large family in the United States.

Seventy-eight persons in an Italian-American family were tested for hepatitis B serologic markers. Fifty-one (65%) had serologic evidence of active or prior hepatitis B infection. Twenty-eight (36%) had evidence of active infection, including twenty-six with hepatitis B surface antigen (HBsAg), and two with antibody to the hepatitis B core antigen only. Severe chronic liver disease was documented in four family members, three of whom had serologic evidence of active hepatitis B infection and the fourth died before the availability of hepatitis B testing. Thirteen of 18 (72%) offspring of six HBsAg positive mothers were HBsAg positive. No epidemiologic explanation of the high prevalence of hepatitis B infection in this family was found, although mother-to-child transmission in years past is a possible explanation.

Female↗
PubMed1981

HLA antigens and HBV infection: evaluation in the chronic carrier state and in a large family.

HLA antigens were determined in 65 apparently well chronic carriers of HBsAg, in race-matched controls and in 42 members of a family with a high frequency of hepatitis B virus infection. The only apparent significant association in the chronic carriers was negative, i.e., no HLA-B7 specificities were found among whites. B7 may confer resistance for whites to chronic infection with hepatitis B. In the family neither active (HBsAg) nor prior (anti-HBs) hepatitis B infection was associated with HLA specificities. HLA antigens in this family failed to provide a clue to the genetics of hepatitis B infection.

Carrier State↗
PubMed1981

Night driving (mesopic) visual acuity in sober male alcoholics with and without liver disease.

Night driving (mesopic) visual acuity and recovery after dazzle has been reported to be reduced in patients with liver disease. Mesopic visual acuity and dazzle recovery were evaluated in 32 patients with alcoholic cirrhosis, 29 alcoholics without liver disease, and 27 age-matched normal controls. All subjects were sober for at least 7 days prior to visual testing, a mean sobriety period of 22 and 39 weeks in alcoholics and cirrhotics, respectively. Serum vitamin A levels and/or dark adaptation were normal in all. Mean best decimal acuities were not significantly different among the groups: alcoholic cirrhotics, 0.32 +/- 0.02; alcoholics, 0.32 +/- 0.02; and normals 0.33 +/- 0.03 at 2 min. Although cirrhotics had significantly higher SGOT and lower albumin levels than alcoholics, mesopic acuity did not relate to liver blood tests. Decimal acuity following a dazzle stimulus was not significantly worse in cirrhotics and alcoholics compared to normals. Sober patients with alcoholic cirrhosis or a history of alcoholism have no evidence of a static mesopic visual defect and therefore may not have impaired night driving vision.

Alcoholism↗