Infectious Hepatitis: A Review of 200 Cases

Hoagland, Charles L.; Shank, Robert E.

doi:10.1001/jama.1946.02870100001001

Cited by 76 publications

(19 citation statements)

References 14 publications

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“…Of 194 cases reported in Detroit between November 1937 and March 1938, only 27 involved persons more than 14 years old (173). In the military epidemics of World War II, the cases reflected the ages of the troops, with the majority ranging from 19 to 40 years old (102,113).…”

Section: Epidemic Hepatitis Amentioning

confidence: 99%

Hepatitis A: Old and New

2001

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The hepatitis A virus (HAV), a picornavirus, is a common cause of hepatitis worldwide. Spread of infection is generally person to person or by oral intake after fecal contamination of skin or mucous membranes; less commonly, there is fecal contamination of food or water. Hepatitis A is endemic in developing countries, and most residents are exposed in childhood. In contrast, the adult population in developed countries demonstrates falling rates of exposure with improvements in hygiene and sanitation. The export of food that cannot be sterilized, from countries of high endemicity to areas with low rates of infection, is a potentially important source of infection. After ingestion and uptake from the gastrointestinal tract, the virus replicates in the liver and is excreted into the bile. Cellular immune responses to the virus lead to destruction of infected hepatocytes with consequent development of symptoms and signs of disease. Humoral immune responses are the basis for diagnostic serologic assays. Acute HAV infection is clinically indistinguishable from other causes of acute viral hepatitis. In young children the disease is often asymptomatic, whereas in older children and adults there may be a range of clinical manifestations from mild, anicteric infection to fulminant hepatic failure. Clinical variants include prolonged, relapsing, and cholestatic forms. Management of the acute illness is supportive, and complete recovery without sequelae is the usual outcome. Research efforts during World War II led to the development of passive immunoprophylaxis. Pooled immune serum globulin is efficacious in the prevention and attenuation of disease in exposed individuals. More recently, active immunoprophylaxis by vaccination has been accomplished. Future eradication of this disease can now be contemplated

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Section: Epidemic Hepatitis Amentioning

confidence: 99%

Hepatitis A: Old and New

2001

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“…In determining changes in liver function during the course of therapy the methods employed were identical with those presented in a previous study (12). Estimation of serum esterase activity was carried out in the Warburg manometric apparatus and the results expressed in terms of the amount of CO2 released from bicarbonate buffer following the hydrolysis of acetyl choline (13).…”

Section: Methodsmentioning

confidence: 99%

The Use of Concentrated Human Serum Albumin in the Treatment of Cirrhosis of the Liver 1

Kunkel¹,

Labby²,

Ahrens³

et al. 1948

J. Clin. Invest.

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The formation of ascites in patients with cirrhosis of the liver probably depends on at least three factors: (1) hypoalbuminemia, (2) portal hypertension, and (3) increased amounts of circulating antidiuretic substance. The relative importance of these factors varies with the individual patients. Although the formation and disappearance of ascites do not correlate perfectly with levels of serum albumin in all patients, in the majority of cases the two findings are coincident and apparently related (1, 2). The use of concentrated human serum albumin in these patients for its osmotic effect would be expected to cause a diuresis. The extent to which this diuresis is produced would depend in large part upon the relative importance of the various factors of ascites production, being most marked in those patients in whom hypoalbuminemia is most specifically at fault.The observations of Janeway (3) and Thorn (4) and their co-workers in patients with liver disease demonstrated that the albumin level of the serum could be raised to normal by repeated injections of albumin. Certain of their patients showed a loss of edema and ascites but the oncotic effects were disappointing in their experience.

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“…Emphasis was laid on strictly enforced rest in bed as a result of studies of the many military personnel who acquired acute infectious hepatitis during World War II. It was advocated by some that bed rest should be continued not only until all symptoms and signs had disappeared, but even until the major liver function tests returned to normal (1,2). Later studies by others (3,4) suggested that the period of bed rest need not be that prolonged.…”

Section: -General Remarksmentioning

confidence: 99%

“…To illustrate this fact data from descriptions of epidemics of infectious hepatitis among military personnel in post-war Germany, and during World War II in the United States, Great Britain, Italy, and the Middle East (1)(2)(3)(34)(35)(36) are presented in Table XX, Appendix II. As might be expected, there was considerable variation in the manner in which the data were handled in each of these reports, and some liberties have been taken in the tabulation to make them as comparable as possible.…”

Section: Rest Effectsmentioning

confidence: 99%