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Biomedical subjects

J Birnbaum

Publications and source records attributed to J Birnbaum.

At least 19 recordsLinked to original sources
PubMed1992

Prevalence of allergy to hymenoptera stings in different samples of the general population.

To get figures of prevalence of systemic reactions (SRs) to hymenoptera sting in adults between the ages of 18 to 65 years, we performed three different surveys using the same questionnaire from 1984 to 1988. The first one was a door-to-door survey in Southeast France, which included 8271 adults and used a questionnaire. The second one, which included 2067 adults, was performed in a health care center and comprised the same questionnaire and venom skin tests in subjects reporting a history of SRs. The third survey was a national poll performed through a home-based national computer network. The percentage of SRs ranged from 0.66% in the second survey including skin tests to 3.3% in the poll survey. The higher prevalence figure in this latter survey may be related to a false-positive history. There was no urban-rural difference in prevalence of SR.

Adolescent↗
PubMed1991

An improved method for the detection of soluble interleukin 2 receptors in liver transplant recipients by flow cytometry.

A new flow cytometric method (FCM) for detection of soluble interleukin 2 receptor (sIL-2R) in serum was established. Using this method, results from one to forty samples can be obtained in less than 2 hr as compared with 5 hr in an ELISA. Comparing over 300 sera samples tested by both methods, we found the FCM to be as specific and sensitive as the ELISA, but even more reproducible. Regression analysis of ELISAt on FCMt showed there is a strong relationship between the two assays and they mimic each other over time. We studied the daily serum levels of sIL-2R by FCM in 18 liver allograft recipients: 7 were in the stable group, 6 in the rejection group, and 5 had both rejection and infection. Low or decreasing sIL-2R levels correlated with absence of rejection. In patients with rejection episodes, a typical elevation of sIL-2R was followed by a rapid decrease of sIL-2R after successful response to rejection therapy. Patients with multiple complications displayed elevated sIL-2R levels. In conclusion, because of its rapid turnover time and accuracy, the FCM has the potential to determine the appropriate timing of post-transplant liver biopsies.

Antibodies, Monoclonal↗
PubMed1991

Medication requirements and house dust mite exposure in mite-sensitive asthmatics.

To better understand the clinical consequences of exposure to house dust mites (HDM), we investigated the relationship between treatment requirements to control symptoms in mite-allergic asthmatic patients and HDM-allergenic levels in their mattresses. This study included 49 asthmatic subjects recruited from an outpatient clinic. The protocol consisted of a questionnaire about the number of asthma attacks and treatment requirements in the last 3 months. Patients provided a sample of house dust collected from their mattresses by a standardized vacuum cleaning procedure. Mean antigen P1 equivalent defined as the sum of major allergens Der pI and Der fI (Ag P1 Eq) level was 1.34 micrograms/g dust in patients who had no treatment, 5.4 micrograms/g dust in patients who took puffs of beta 2-agonists only when required and 17.8 micrograms/g dust in patients who required daily long-term treatment. Similar relationships were demonstrated between mean Ag P1 Eq levels and the number of asthma attacks. These data support the clinical role of allergenic exposure in HDM-allergic asthmatics.

Adolescent↗
PubMed1991

Altitude and allergy to house-dust mites. A paradigm of the influence of environmental exposure on allergic sensitization.

To further investigate the possibility of a cause and effect relationship between exposure to house-dust mite (HDM) allergens and respiratory disease associated with dust mite sensitivity, we compared schoolchildren living in the Alps, where exposure to HDM is low, with those living at sea level, where it is high. The study included 933 schoolchildren from the fourth and fifth grades. The protocol included the standardized 1978 American Thoracic Society (ATS) questionnaire for children, skin testing using common aero-allergens and controls, and antigenic measurements of dust samples from mattresses (Group I antigen). The prevalence of asthma with positive skin test to HDM and the overall prevalence of positive skin test to HDM were significantly lower in mountain schoolchildren. The mean geometric HDM antigenic level in mattresses was much lower in the Alps (0.36 micrograms/g dust) than at sea level (15.8 micrograms/g dust). In contrast, the prevalence of hay fever and positive skin test to grass pollens as well as the overall prevalence of positive skin tests to grass pollens were significantly higher in the Alps. These data illustrate a striking relationship between exposure to environmental allergens and atopic sensitization.

Altitude↗
PubMed1991

Extrinsic asthma and environmental allergens.

House dust mites allergens are one of the most common antigens able to induce a high degree of sensitization in a general population. Owing to the possibility of quantifying the amount of major mite allergens in the environment, epidemiological studies have led to propose threshold values above which there is an increased risk for the occurrence of mite sensitizing, for the development of asthma and for the occurrence of symptoms. All these studies and some others dealing with the number of mites in house dust support the hypothesis that exposure to house dust mites may have a major influence on developing allergic diseases.

Allergens↗
PubMed1990

[Alcohol-related admissions in a community hospital].

We reviewed 150 alcoholic patients (1.3% of all admissions) hospitalized in this department during 1983-1987 and compared them with a random sample of 450 other patients in the department during the same period. In the alcoholic group were more males, an increased prevalence of those of Yemenite and Indian origin, and a higher rate of unemployed. The clinical presentation was heterogenous. In 26% of the chronic alcoholics no abnormality related to alcoholic injury was detected. The other patients in that group suffered from a variety of clinical problems related to alcohol. In 41% the immediate cause of admission was related to chronic alcoholism, and in others (31%) we observed alcohol-related pathology in addition to the main cause of hospitalization. We wish to increase awareness of the medical problems of chronic alcoholics encountered in a community hospital in order to promote quicker diagnosis, avoid unnecessary diagnostic procedures, and lead to better medical care.

Alcoholism↗
PubMed1990

Immunotherapy in allergic respiratory diseases.

Much more work is needed to specify the correct indications for immunotherapy in respiratory allergic diseases. Immunotherapy with pollen and mite extracts has shown some clinical efficacy versus placebo in controlled studies in allergic rhinitis and/or asthma. However, controlled studies comparing the cost, the risk factors and the efficacy of immunotherapy versus treatment with antihistaminic drugs, bronchodilators and topical steroids are needed. Additional studies are needed to established the place of immunotherapy in animal danders and mould allergy. In any case, before initiating immunotherapy in respiratory allergy the following questions must be answered: is there sufficient evidence of a close relationship between symptoms and allergen exposure? is it possible to achieve efficient allergen avoidance? is simple drug treatment no sufficient? is there evidence in the literature of effectiveness of IT for this allergen? is the patient able to comply with a long and constraining treatment?

Allergens↗
PubMed1989

Immunoheterogeneity of parathyroid hormone in parathyroid cysts: diagnostic implications.

Parathyroid cysts are uncommon lesions of the neck leading to hypercalcemia in a significant percentage of cases. The distinction between parathyroid and thyroid cysts is difficult to make on a clinical basis alone and relies on the demonstration of elevated PTH levels in cyst fluid. We describe a case of a parathyroid cyst in which intact PTH (1-84) levels were misleadingly low while midmolecule 44-68 PTH was markedly elevated. To explain this discrepancy, we studied cyst fluid from this and two other patients using Sephadex G-75 gel chromatography. Fractions were analyzed using an immunoradiometric assay for intact hPTH (1-84) and a RIA specific for the midmolecular 44-68 region of hPTH. Immunoreactivity corresponding to hPTH (1-84) was absent in the first case but present in the remaining two. Immunoreactive peaks corresponding to PTH fragments were demonstrable in all three cyst samples. Patients with elevated hPTH (1-84) in cyst fluid were hypercalcemic; in contrast, the patient with a low cyst level of hPTH (1-84) was normocalcemic despite having markedly elevated levels of midmolecule PTH (44-68) in both serum and cyst fluid. Parathyroid cysts may thus produce fragments rather than intact PTH; reliance on an intact hPTH assay could lead to misdiagnosis. The measurement of PTH by a midmolecular assay may be preferable to the measurement of intact PTH in the evaluation of fluid from cystic neck masses.

Aged↗
PubMed1989

Partial adrenalectomy for pheochromocytoma with maintenance of adrenocortical function.

A 30-yr-old woman with malignant hypertension was found to have biochemical evidence of pheochromocytoma. Bilateral adrenal tumors were demonstrated on computerized tomographic scanning and confirmed at the time of surgery. Complete removal of one adrenal gland with partial removal of the other adrenal gland resulted in normalization of her blood pressure and biochemical parameters (norepinephrine and epinephrine) with preservation of adrenocortical function.

Adrenal Cortex↗
PubMed1988

Lithium stimulates the release of human parathyroid hormone in vitro.

The effect of lithium on PTH release from human parathyroid tissue was studied using a perifusion system and an immunoradiometric assay for intact human PTH. Tissue was obtained from three patients undergoing surgery for thyroid disease, three patients with secondary hyperparathyroidism due to chronic renal insufficiency, and four patients with primary hyperparathyroidism due to a parathyroid adenoma. Addition of lithium in concentrations equivalent to the therapeutic serum levels normally attained in man (1.3 mmol/L) resulted in a significant (P less than 0.05) increase in PTH release under normocalcemic (1.15 mmol/L) conditions from normal and hyperplastic tissues. The magnitude of the lithium-induced response of PTH release ranged from a 1.4- to 5.3-fold increase above basal levels (perifusion with 1.15 mmol/L calcium alone) and was comparable to the response during a low calcium (0.42 mmol/L) perifusion. Although the response to lithium was delayed compared to that of hypocalcemia, PTH returned to basal levels immediately after removal of either stimulator. In contrast, parathyroid adenomas did not respond to either lithium or hypocalcemia in a characteristic manner, but, rather, functioned in an autonomous fashion with repeated pulsatile bursts of PTH release that were not suppressible even under hypercalcemic (1.70 mmol/L) conditions. These in vitro studies suggest that lithium therapy may elevate serum PTH levels in some patients and could, thus, be responsible for hypercalcemia in them.

Adenoma↗
PubMed1988

[The role of alpha-amylase in baker's asthma].

We report a case of asthma in a baker provoked by an additive which is generally used in bread making, namely alpha-amylase, an extract of Aspergillus oryzae. Skin tests to alpha-amylase were positive in a concentration of 0.1 micrograms/ml. Specific IgE was detected to this enzyme. A provocation test to alpha-amylase was positive with a fall of the FEV1 of 42%. Provocation tests to flour gave a negative immediate and delayed reaction. Progress was made towards the disappearance of symptoms after several months of avoiding the allergen. This observation has enabled us to show the specificity of the allergy to alpha-amylase, a glycolytic enzyme, coming in the group of occupational diseases n. 63 (asthma due to lyophilised enzymes) whereas baker's asthma is at n. 66.

Adult↗