The Yield of Multiphasic Screening

Bates, Barbara

doi:10.1001/jama.1972.03210010054012

Cited by 42 publications

(3 citation statements)

References 12 publications

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“…These low levels could be attributed to the rather long average duration of jaundice of 17.43 days before patients were recruited into the study. The AST to ALT ratio is typically less than one in acute viral hepatitis (18) though occasionally the ratio may be higher and even exceed two (19). The ratio in this study was comparable to one of 1.8 reported by Lodenyo et al (20) in a similar study done in South Africa.…”

Section: Discussionsupporting

confidence: 82%

Prevalence of hepatitis A, B, C and human immunodeficiency virus seropositivity among patients with acute icteric hepatitis at the Kenyatta National Hospital, Nairobi

Atina

et al. 2004

E Af Med Jrnl

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in 41.7%, 26.2%, and 7.1% of the patients respectively, 13.1% of the patients were HBsAg carriers while 30.1% of all patients were HIV positive. Thirty two patients did not have evidence of hepatitis A, B, or C infection and this group was significantly associated with HIV infection (p=0.003). Conclusion: Hepatitis A was the commonest overall type of acute icteric hepatitis seen at the KNH, and among patients aged 15 years and below. Hepatitis B was the leading identified cause of acute hepatitis among those aged over 15 years. Hepatitis C accounted for 7.1% of acute icteric hepatitis 30.1% of all patients and 50% of those admitted with acute hepatitis were also HIV positive.

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Section: Discussionsupporting

confidence: 82%

Prevalence of hepatitis A, B, C and human immunodeficiency virus seropositivity among patients with acute icteric hepatitis at the Kenyatta National Hospital, Nairobi

Atina

et al. 2004

E Af Med Jrnl

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“…Analysis of data from the Third National Health and Nutrition Examination Survey (NHANES III) in the United States showed a prevalence of elevated alanine aminotransferase (ALT) or aspartate aminotransferase (AST) to be as high as 7.9% 1. This figure is considerably higher than the 1–4% prevalence rate reported in earlier studies,2 3 and indicates that the prevalence of abnormal liver tests in the general population has increased. Although many cases of elevated aminotransferase levels can be explained by the consumption of large quantities of alcohol or the presence of hepatitis C virus (HCV) infection, a great number of cases typically remain unexplained 1.…”

mentioning

confidence: 87%

Fast-food-based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects

Kechagias

Ernersson

Dahlqvist

et al. 2008

Gut

168

118

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Objective:To study the effect of fast-food-based hyper-alimentation on liver enzymes and hepatic triglyceride content (HTGC).Design:Prospective interventional study with parallel control group.Setting:University Hospital of Linköping, Sweden.Participants:12 healthy men and six healthy women with a mean (SD) age of 26 (6.6) years and a matched control group.Intervention:Subjects in the intervention group aimed for a body weight increase of 5–15% by eating at least two fast-food-based meals a day with the goal to double the regular caloric intake in combination with adoption of a sedentary lifestyle for 4 weeks.Main outcome measures:Weekly changes of serum aminotransferases and HTGC measured by proton nuclear magnetic resonance spectroscopy at baseline and after the intervention.Results:Subjects in the intervention group increased from 67.6 (9.1) kg to 74.0 (11) kg in weight (p<0.001). Serum ALT increased from 22.1 (11.4) U/l at study start to an individual mean maximum level of 97 (103) U/l (range 19.4–447 U/l). Eleven of the 18 subjects persistently showed ALT above reference limits (women >19 U/l, men >30 U/l) during the intervention. Sugar (mono- and disaccharides) intake during week 3 correlated with the maximal ALT/baseline ALT ratio (r = 0.62, p = 0.006). HTGC increased from 1.1 (1.9)% to 2.8 (4.8)%, although this was not related to the increase in ALT levels. ALT levels were unchanged in controls.Conclusion:Hyper-alimentation per se can induce profound ALT elevations in less than 4 weeks. Our study clearly shows that in the evaluation of subjects with elevated ALT the medical history should include not only questions about alcohol intake but also explore whether recent excessive food intake has occurred.

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“…Numerous studies have found biochemistry screening tests wanting at one or more of the steps necessary to make testing worthwhile (10)(11)(12). One extensive review of admission biochemistries for 1000 patients revealed no new findings that were unequivocally beneficial (13).…”

Section: Use Of Clinical Chemistry Testsmentioning

confidence: 99%