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Biomedical subjects

I E Roeckel

Publications and source records attributed to I E Roeckel.

18 recordsLinked to original sources
PubMed2000

Commentary: Iron metabolism in hepatitis C infection.

Hepatitis C virus (HCV) infections have started to decline, but up to 10,000 deaths each year are the consequence of chronic liver disease, following the infection. Laboratory testing identifies HCV-infected individuals using positive recombinant immunoblot assays to detect the presence of the antibody; the diagnosis is confirmed by detecting HCV RNA in serum. HCV-infected patients who have large accumulations of hepatic iron have not responded well to interferon therapy, compared to patients with normal hepatic iron stores. Physicians who treat patients infected with HCV should be aware of the detrimental effect of excess liver iron on interferon therapy. The degree of hepatic iron overload should be assessed and the reason for the excess iron should be investigated. Phlebotomy is the most practical method for iron removal and is well tolerated by patients with HCV infection.

Hepatitis C↗
PubMed1977

Thrombocytopenia and its management in the surgical patient needing multiple reconstructive procedures.

Thrombocytopenic patients with surgically correctable lesions such as radial clubhands are too often repeatedly transfused with randomly pooled platelets. This is followed by a clinical rejection of the foreign protein and rapid destruction of the platelets. There may be excessive bleeding episodes. Tissue typing technics now available can provide antigenically compatible platelet concentrates which elicit few of these reactions. Therefore, multiple reconstructive procedures can be achieved with a greater safety margin than previously possible.

Blood Transfusion↗
PubMedDate not supplied

Cutaneous larva migrans, an occupational disease.

Creeping skin eruption is known to follow exposure to canine and feline hookworm larvae found in contaminated soil encountered in humid, tropical and subtropical regions. A little known hazard of similar infections exists among veterinarians and laboratory workers exposed to Strongyloides larvae from horses located in temperate climates. The evolving clinical picture is described in detail. Continued exposure may lead to a state of hypersensitivity to the parasitic protein resulting in severe hyperimmune reactions. The invasiveness of Strongyloides larvae through intact skin and the pathologic changes associated with infection were demonstrated in a rabbit.

Adult↗
PubMedDate not supplied

Do we have to rethink serologic markers used to diagnose hepatitis B infection?

The recent addition of testing volunteer blood donors for antibody to hepatitis B core antigen (anti-HBc) has raised questions not apparent when such testing is applied to hepatitis B (HB) infected patients. The review of published studies, and our own, demonstrates that it is difficult to evaluate false positive results. Some patients appear to lose antibody to hepatitis B surface antigen (anti-HBs) but not antibody to hepatitis B core antigen (anti-HBc), thus raising the possibility of disease transmission. It is anticipated that additional investigation of individuals positive for anti-HBc only by response to hepatitis B vaccine permits clarification of their immune status and absence of infectivity.

Blood Donors↗
PubMedDate not supplied

Past and future of providing matched, unrelated donors for marrow transplantation.

Prior to 1979, bone marrow transplants were only performed with histocompatible sibling donors. Once it was established that histocompatible, unrelated donors could donate marrow for transplantation, the recruitment of such donors needed to be standardized. Blood donor centers had already identified the histocompatibility locus antigen (HLA) typing for donors who could be recruited to donate bone marrow. Recruiting a large number of donors required systematic evaluation and testing according to defined standards which were published in 1988 by the National Marrow Donor Program (NMDP). Peripheral stem cell collection (PBS) has been added as a transplant source. It promises additional therapeutic modalities, such as gene splicing to address other than cancer therapy.

Academic Medical Centers↗
PubMedDate not supplied

Understanding iron absorption and metabolism, aided by studies of hemochromatosis.

Duodenal iron absorption from food is selectively blocked to prevent iron intoxication. The prime example of pathologic increase in intestinal iron absorption is seen in patients with hemochromatosis. They suffer iron damage to the heart, liver, and other tissues resulting in premature death if the iron is not removed by vigorous phlebotomy. Examples of overcoming the intestinal barrier to iron are alcohol consumption, vitamin preparations with vitamin C, and iron consumed by individuals without anemia. Endogenous generation of excess iron by hemolysis, owing to abnormal hemoglobin or many transfusions, are not controlled by the intestinal barrier.

Ferritins↗
PubMedDate not supplied

Long-term maintenance of immunity in patients with common variable immune deficiency by plasma transfusion.

The AIDS crisis and the fear of blood product contamination stimulated the development of a designated plasma collection and transfusion for patients with common variable immune deficiency. Four patients have been maintained over 1 year; 5 years and 10 months; 8 years and 7 months; and 12 years. A new crisis affecting commercial IgG manufacturing, owing to recalls, has made the life saving product scarce, threatening patients' health maintenance. Our experience over a long time has demonstrated that plasma transfusion is equivalent to management with commercial IgG. The program of product collection and patient management includes testing the collected plasma for IgG content, selecting ABO compatible plasma, and following patients with IgG trough levels, prior to each transfusion, to assure sufficient immune globulin administration.

Blood Component Removal↗