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Terefe FT, Yang B, Jemal K, Ayana D, Adefris M, Awol M, Tesema M, Dagne B, Abeje S, Bantie A, Loewenberger M, Adams SJ, Mendez I. Advancing Antenatal Care in Ethiopia: The Impact of Tele-Ultrasound on Antenatal Ultrasound Access in Rural Ethiopia. Telemed J E Health 2024. [PMID: 39229684 DOI: 10.1089/tmj.2024.0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024] Open
Abstract
Introduction: Access to antenatal ultrasound is limited in low-income countries such as Ethiopia. Virtual care platforms that facilitate supervision and mentoring for ultrasound scanning may improve patient access by facilitating task-sharing of antenatal ultrasound with midlevel providers. The purpose of this study was to assess the feasibility of a large volume tele-ultrasound program in Ethiopia, its impact on antenatal care (ANC) and patient access, and its sustainability as it transitioned from a pilot project to a continuing clinical program. Methods: Health care providers at two health centers in the North Shoa Zone, Ethiopia, performed antenatal tele-ultrasound exams with remote guidance from obstetricians located in urban areas. Data regarding ANC and ultrasound utilization, participant travel, ultrasound findings, specialist referrals, and participant experience were collected through a mobile app. Results: Between November 2020 and December 2023, 7,297 tele-ultrasound exams were performed. Of these, 489 tele-ultrasound exams were performed during the period of data collection from October to December 2022. The availability of tele-ultrasound at the two health centers significantly reduced participant travel distance (4.2 km vs. 10.2 km; p < 0.01; one-way distance). Most participants (99.2%) indicated the tele-ultrasound service was very important or important, with high levels of satisfaction. Clinically significant findings were identified in 26 cases (5.3%), leading to necessary referrals. Conclusion: This study demonstrated the feasibility of a large volume tele-ultrasound program in Ethiopia, its impact on improving the quality of ANC, and its sustainability. These findings lay a foundation upon which low-income countries can develop tele-ultrasound programs to improve antenatal ultrasound access.
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Affiliation(s)
- Felagot Taddese Terefe
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bonnie Yang
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Kemal Jemal
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Dereje Ayana
- Department of Medicine, College of Medicine and Health Sciences, Salale University, Fitche, Ethiopia
| | - Mulat Adefris
- Department of Obstetrics and Gynecology, University of Gondar, Gondar, Ethiopia
| | - Mukemil Awol
- Department of Midwifery, College of Medicine and Health Sciences, Salale University, Fitche, Ethiopia
| | - Mengistu Tesema
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fitche, Ethiopia
| | - Bewunetu Dagne
- Department of Computer Science, College of Natural Sciences, Salale University, Fitche, Ethiopia
| | - Sandra Abeje
- Canadian Physicians for Aid and Relief, Addis Ababa, Ethiopia
| | - Alehegn Bantie
- Canadian Physicians for Aid and Relief, Addis Ababa, Ethiopia
| | | | - Scott J Adams
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Canada
| | - Ivar Mendez
- Department of Surgery, University of Saskatchewan, Saskatoon, Canada
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Carrasco D, Guedes-Martins L. Cardiac Axis in Early Gestation and Congenital Heart Disease. Curr Cardiol Rev 2024; 20:CCR-EPUB-137797. [PMID: 38279755 PMCID: PMC11071675 DOI: 10.2174/011573403x264660231210162041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/06/2023] [Accepted: 10/17/2023] [Indexed: 01/28/2024] Open
Abstract
Congenital heart defects represent the most common structural anomalies observed in the fetal population, and they are often associated with significant morbidity and mortality. The fetal cardiac axis, which indicates the orientation of the heart in relation to the chest wall, is formed by the angle between the anteroposterior axis of the chest and the interventricular septum of the heart. Studies conducted during the first trimester have demonstrated promising outcomes with respect to the applicability of cardiac axis measurement in fetuses with congenital heart defects as well as fetuses with extracardiac and chromosomal anomalies, which may result in improved health outcomes and reduced healthcare costs. The main aim of this review article was to highlight the cardiac axis as a reliable and powerful marker for the detection of congenital heart defects during early gestation, including defects that would otherwise remain undetectable through the conventional four-chamber view.
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Affiliation(s)
- D. Carrasco
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- Centro de Medicina Fetal, Medicina Fetal Porto, Serviço de Obstetrícia - Centro Materno Infantil do Norte, Porto 4099-001, Portugal
| | - L. Guedes-Martins
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- Centro de Medicina Fetal, Medicina Fetal Porto, Serviço de Obstetrícia - Centro Materno Infantil do Norte, Porto 4099-001, Portugal
- Centro Hospitalar Universitário do Porto EPE, Centro Materno Infantil do Norte, Departamento da Mulher e da Medicina Reprodutiva, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal
- Unidade de Investigação e Formação-Centro Materno Infantil do Norte, 4099-001 Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, 4200-319, Portugal
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Tang J, Han J, Xie B, Xue J, Zhou H, Jiang Y, Hu L, Chen C, Zhang K, Zhu F, Lu L. The Two-Stage Ensemble Learning Model Based on Aggregated Facial Features in Screening for Fetal Genetic Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2377. [PMID: 36767743 PMCID: PMC9914999 DOI: 10.3390/ijerph20032377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/18/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
With the advancement of medicine, more and more researchers have turned their attention to the study of fetal genetic diseases in recent years. However, it is still a challenge to detect genetic diseases in the fetus, especially in an area lacking access to healthcare. The existing research primarily focuses on using teenagers' or adults' face information to screen for genetic diseases, but there are no relevant directions on disease detection using fetal facial information. To fill the vacancy, we designed a two-stage ensemble learning model based on sonography, Fgds-EL, to identify genetic diseases with 932 images. Concretely speaking, we use aggregated information of facial regions to detect anomalies, such as the jaw, frontal bone, and nasal bone areas. Our experiments show that our model yields a sensitivity of 0.92 and a specificity of 0.97 in the test set, on par with the senior sonographer, and outperforming other popular deep learning algorithms. Moreover, our model has the potential to be an effective noninvasive screening tool for the early screening of genetic diseases in the fetus.
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Affiliation(s)
- Jiajie Tang
- School of Information Management, Wuhan University, Wuhan 430072, China
- Institute of Pediatrics, Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510180, China
| | - Jin Han
- Institute of Pediatrics, Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510180, China
- Graduate School, Guangzhou Medical University, Guangzhou 511436, China
| | - Bingbing Xie
- School of Information Management, Wuhan University, Wuhan 430072, China
| | - Jiaxin Xue
- Institute of Pediatrics, Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510180, China
- Graduate School, Guangzhou Medical University, Guangzhou 511436, China
| | - Hang Zhou
- Institute of Pediatrics, Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510180, China
- Graduate School, Guangzhou Medical University, Guangzhou 511436, China
| | - Yuxuan Jiang
- Institute of Pediatrics, Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510180, China
| | - Lianting Hu
- Medical Big Data Center, Guangdong Provincial People’s Hospital, Guangzhou 510080, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangzhou 510080, China
| | - Caiyuan Chen
- Institute of Pediatrics, Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510180, China
- Graduate School, Guangzhou Medical University, Guangzhou 511436, China
| | - Kanghui Zhang
- School of Information Management, Wuhan University, Wuhan 430072, China
| | - Fanfan Zhu
- School of Information Management, Wuhan University, Wuhan 430072, China
| | - Long Lu
- School of Information Management, Wuhan University, Wuhan 430072, China
- Institute of Pediatrics, Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510180, China
- Center for Healthcare Big Data Research, The Big Data Institute, Wuhan University, Wuhan 430072, China
- School of Public Health, Wuhan University, Wuhan 430072, China
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Evaluation of the Association between Fetal Cardiac Disorders with Choroid Plexus Cyst in Fetuses. J Cardiovasc Dev Dis 2022; 9:jcdd9020060. [PMID: 35200713 PMCID: PMC8880279 DOI: 10.3390/jcdd9020060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/18/2022] [Accepted: 02/10/2022] [Indexed: 11/17/2022] Open
Abstract
Choroid plexus cysts (CPCs) are often transient and benign findings observed in pregnancy screenings. This study aimed to examine the association between the frequency of congenital heart diseases and the detection of CPCs. In this prospective case-control study, pregnant mothers with no predisposing risk factors for the development of fetal cardiac abnormalities were eligible for entry. Based on the presence or absence of CPCs on ultrasound, the enrolled fetuses were divided into two groups. All patients (n = 100) underwent two-dimensional and color Doppler echocardiography to identify potential cardiac anomalies. Overall, CPCs were detected in 53 enrolled fetuses, and the remainder were enrolled as controls (n = 47). Pathological findings, such as echogenic intracardiac focus (EIF), ductal spasm, atrial septal defect (ASD), pericardial effusion, cardiomyopathy, and congenital heart disease were found in neither group. In the CPC group, two mild and six trivial cases of tricuspid regurgitation (TR) were detected. In the controls, five cases of trivial TR were identified. In conclusion, the presence of CPCs was not associated with significant functional or structural fetal cardiac abnormalities, which may be due to altered developmental mechanisms.
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Abstract
Experimental work regarding corrective actions on chromosomes and genes, and control of gene products is yielding promising results. It opens the way to advances in dealing with the etiological aspects of Down syndrome and may lead to important changes in the life of individuals affected with this condition. A small number of molecules are being investigated in pharmacological research that may have positive effects on intellectual functioning. Studies of the pathological consequences of the amyloid cascade and the TAU pathology in the etiology of Alzheimer disease (AD), which is more frequent and occuring earlier in life in persons with Down syndrome (DS), are presented. The search for biological markers of AD and ways for constrasting its early manifestations are also discussed.
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Affiliation(s)
- Jean A. Rondal
- University of Liège, Cognitive Sciences, Building 32, Sart Tilman, Liège 4000, Belgium
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6
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Sukarova-Angelovska E, Kocova M, Sukarova-Stefanovska E, Ilieva G, Hristova-Dimkovska T, Kostadinova-Kunovska S. Prenatal Diagnosis of Cryptic Translocation t(5p;17q) with Fluorescent In Situ Hybridization. JOURNAL OF FETAL MEDICINE 2018. [DOI: 10.1007/s40556-018-0161-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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7
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Campion A, Lee C, Bao N, Lazareff J. A parental perspective concerning barriers to care for neural tube defects in China. Surg Neurol Int 2017; 8:195. [PMID: 28904822 PMCID: PMC5590351 DOI: 10.4103/sni.sni_384_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 02/28/2017] [Indexed: 11/20/2022] Open
Abstract
Background: The People's Republic of China (PRC) has the highest incidence of neural tube defects (NTDs) in the world. NTDs remain a significant contributor to the global burden of disease amendable to surgical care; however, no studies to date have evaluated the patients’ perspective regarding perceived barriers to care. Methods: The study was conducted at the Shanghai Children's Medical Center (SCMC) between 6/11/2014 and 7/17/2014. Surveys were administered to families presenting to the clinic of the SCMC director for Pediatric Neurosurgery. Additionally, orphaned patients under the care of the Baobei Foundation were surveyed for comparison. Participants were allowed to mark as many barriers on the survey as they deemed relevant to their experience. Results: A total of 69 patients were surveyed. The most frequently chosen barrier to care, with a P value < 10-5, was that the referring physician did not know enough about the child's condition. As compared to the Baobei Foundation orphans, surveyed patients presented at an older age for initial treatment (7 months versus 1 month, P value = 0.001), and visited more hospitals before reaching SCMC (3.14 versus 1.0, P value < 10-5). Conclusions: The results of this study highlight the referring physician as a primary barrier to care. The younger age at time of treatment for Baobei orphans born with NTDs supports this finding, as they essentially bypassed the referral process. An elaboration on reasons for this real or perceived barrier may provide insight into a means for expedited diagnosis and treatment of NTDs within the PRC.
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Affiliation(s)
- Andrew Campion
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Clement Lee
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Nan Bao
- Department of Neurosurgery, Shanghai Children's Medical Center, Shanghai, China
| | - Jorge Lazareff
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,UCLA Center for World Health at the David Geffen School of Medicine, Los Angeles, California, USA
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8
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Bondioni MP, Pazzaglia UE, Izzi C, Di Gaetano G, Laffranchi F, Baldi M, Prefumo F. Comparative X-ray morphometry of prenatal osteogenesis imperfecta type 2 and thanatophoric dysplasia: a contribution to prenatal differential diagnosis. Radiol Med 2017; 122:880-891. [PMID: 28674909 DOI: 10.1007/s11547-017-0784-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/16/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of the paper was to assess the morphometric parameters to improve the specificity of the ultrasound (US) signs for the early differential diagnosis between two lethal dysplasias, as thanatophoric dysplasia (TD) and osteogenesis imperfecta type 2 (OI-2). METHOD The diaphyseal length and the bowed shape of long bones associated with vertebral body dimension assessment were investigated in a group of 14 pregnancy terminations carried out in the time period 2007-2013. The definitive diagnosis was established after pregnancy termination by means of skeletal standardized X-rays, histopathology and gene analysis. RESULTS TD and OI-2 long bones were significantly shorter than controls. No significant differences were observed between the two dysplasias. The bowing angle was higher in OI-2; a true angulation or eventually axial displacement was present only in the latter. Furthermore, they did not show any evidence of vertebral collapse. The thanatophoric dysplasia presented less bowed long bones, and never true angulation. The spine was steadily characterized by flattened anterior vertebral bodies. CONCLUSION Long bone shortening is not a sufficient and accurate sign for early sonographic differential diagnosis between TD and OI-2. Angled diaphysis, axial diaphyseal displacement and a conserved vertebral body height in the prenatal period support the diagnosis of osteogenesis imperfecta type 2, while moderately regular bowed diaphysis associated with platyspondyly that of thanatophoric dysplasia.
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Affiliation(s)
- Maria Pia Bondioni
- Pediatric Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, P.le Spedali Civili n. 1, 25100, Brescia, Italy.
| | - Ugo Ernesto Pazzaglia
- Orthopaedic Clinic, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Claudia Izzi
- Prenatal Diagnosis Unit, Department of Obstretics and Gynecology, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giuseppe Di Gaetano
- Pediatric Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, P.le Spedali Civili n. 1, 25100, Brescia, Italy
| | - Francesco Laffranchi
- Pediatric Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, P.le Spedali Civili n. 1, 25100, Brescia, Italy
| | - Maurizia Baldi
- Genetic Laboratory Galliera Hospital Genova, Genoa, Italy
| | - Federico Prefumo
- Prenatal Diagnosis Unit, Department of Obstretics and Gynecology, ASST Spedali Civili of Brescia, Brescia, Italy
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Hakami F, Dillon MW, Lebo M, Mason-Suares H. Retrospective study of prenatal ultrasound findings in newborns with a Noonan spectrum disorder. Prenat Diagn 2016; 36:418-23. [DOI: 10.1002/pd.4797] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 02/10/2016] [Accepted: 02/22/2016] [Indexed: 01/26/2023]
Affiliation(s)
- Fahad Hakami
- Departments of Pathology; Harvard Medical School and Brigham and Women's Hospital; Boston MA USA
- Laboratory for Molecular Medicine; Partners HealthCare Personalized Medicine; Cambridge MA USA
- Department of Pathology and Laboratory Medicine; King Abdulaziz Medical City-WR, King Saud bin Abdulaziz University for Health Sciences; Jeddah Kingdom of Saudi Arabia
| | - Mitchell W. Dillon
- Laboratory for Molecular Medicine; Partners HealthCare Personalized Medicine; Cambridge MA USA
| | - Matthew Lebo
- Departments of Pathology; Harvard Medical School and Brigham and Women's Hospital; Boston MA USA
- Laboratory for Molecular Medicine; Partners HealthCare Personalized Medicine; Cambridge MA USA
| | - Heather Mason-Suares
- Departments of Pathology; Harvard Medical School and Brigham and Women's Hospital; Boston MA USA
- Laboratory for Molecular Medicine; Partners HealthCare Personalized Medicine; Cambridge MA USA
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Kazemi M, Salehi M, Kheirollahi M. Down Syndrome: Current Status, Challenges and Future Perspectives. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2016. [PMID: 27942498 DOI: 10.22088/acadpub.bums.5.3.125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Down syndrome (DS) is a birth defect with huge medical and social costs, caused by trisomy of whole or part of chromosome 21. It is the most prevalent genetic disease worldwide and the common genetic cause of intellectual disabilities appearing in about 1 in 400-1500 newborns. Although the syndrome had been described thousands of years before, it was named after John Langdon Down who described its clinical description in 1866. Scientists have identified candidate genes that are involved in the formation of specific DS features. These advances in turn may help to develop targeted therapy for persons with trisomy 21. Screening for DS is an important part of routine prenatal care. Until recently, noninvasive screening for aneuploidy depends on the measurement of maternal serum analytes and ultrasonography. More recent progress has resulted in the development of noninvasive prenatal screening (NIPS) test using cell-free fetal DNA sequences isolated from a maternal blood sample. A review on those achievements is discussed.
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Affiliation(s)
- Mohammad Kazemi
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.; Medical Genetic Center of Genome, Isfahan, Iran.; Pediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansoor Salehi
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.; Medical Genetic Center of Genome, Isfahan, Iran.; Pediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Kheirollahi
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.; Pediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
Pediatricians are the first contact of a child with genetic disorders such as Down Syndrome. After diagnosis, parents often express and wish that if it was possible to detect it during pregnancy and could it be avoided in the future pregnancy. This makes it essential that pediatricians should have some idea about the basic screening methods and strategy used during pregnancy.
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Affiliation(s)
- Seema Kapoor
- Departments of Pediatrics amd #Gynecology and Obstetrics, MAMC and associated Lok Nayak Hospital; and *Division of Genetics, Department of Pediatrics, AIIMS; New Delhi, India. Correspondence to: Dr Seema Kapoor, Division of Genetics, Department of Pediatrics, MAMC and associated Lok Nayak Hospital, New Delhi 110 002, India.
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12
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Diogo R, Smith CM, Ziermann JM. Evolutionary developmental pathology and anthropology: A new field linking development, comparative anatomy, human evolution, morphological variations and defects, and medicine. Dev Dyn 2015; 244:1357-74. [DOI: 10.1002/dvdy.24336] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 08/10/2015] [Accepted: 08/12/2015] [Indexed: 01/24/2023] Open
Affiliation(s)
- Rui Diogo
- Department of Anatomy; Howard University College of Medicine; Washington DC
| | | | - Janine M. Ziermann
- Department of Anatomy; Howard University College of Medicine; Washington DC
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13
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Asim A, Kumar A, Muthuswamy S, Jain S, Agarwal S. "Down syndrome: an insight of the disease". J Biomed Sci 2015; 22:41. [PMID: 26062604 PMCID: PMC4464633 DOI: 10.1186/s12929-015-0138-y] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 04/22/2015] [Indexed: 01/19/2023] Open
Abstract
Down syndrome (DS) is one of the commonest disorders with huge medical and social cost. DS is associated with number of phenotypes including congenital heart defects, leukemia, Alzeihmer's disease, Hirschsprung disease etc. DS individuals are affected by these phenotypes to a variable extent thus understanding the cause of this variation is a key challenge. In the present review article, we emphasize an overview of DS, DS-associated phenotypes diagnosis and management of the disease. The genes or miRNA involved in Down syndrome associated Alzheimer's disease, congenital heart defects (AVSD), leukemia including AMKL and ALL, hypertension and Hirschprung disease are discussed in this article. Moreover, we have also reviewed various prenatal diagnostic method from karyotyping to rapid molecular methods - MLPA, FISH, QF-PCR, PSQ, NGS and noninvasive prenatal diagnosis in detail.
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Affiliation(s)
- Ambreen Asim
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India.
| | - Ashok Kumar
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India.
| | - Srinivasan Muthuswamy
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India.
| | - Shalu Jain
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India.
| | - Sarita Agarwal
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India.
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Abstract
Ultrasonography is a safe, cost-effective tool used to prenatally detect common musculoskeletal conditions, including clubfoot, skeletal dysplasias, limb-length discrepancies, spinal abnormalities, and hand and other upper extremity deformities. With increased detection of such abnormalities, prenatal parental counseling by orthopaedic surgeons is being requested more frequently. Counseling is important for family education on prognosis and treatment options. A thorough understanding of the common musculoskeletal conditions diagnosed on prenatal ultrasonography, classification of these conditions, and the correlations of these classifications to postnatal severity allows the orthopaedic surgeon to conduct well-informed counseling sessions with families. Accurate information and counseling aids parents in understanding their child's diagnosis, assists clinicians in planning treatment algorithms, and optimizes family preparedness.
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15
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Chen CY, Hwu YM, Chen CP, Chang CC. Quantitative analysis of total β-subunit of human chorionic gonadotropin concentration in urine by immunomagnetic reduction to assist in the diagnosis of ectopic pregnancy. Int J Nanomedicine 2015; 10:2475-83. [PMID: 25848265 PMCID: PMC4386805 DOI: 10.2147/ijn.s81201] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The initial diagnosis of ectopic pregnancy depends on physical examination, ultrasound, and serial measurements of total β-subunit of human chorionic gonadotropin (hCGβ) concentrations in serum. The aim of this study was to explore the possibility of using quantitative analysis of total hCGβ in urine rather than in serum by immunomagnetic reduction (IMR) assay as an alternative method to diagnose an ectopic pregnancy. METHODS We established a standard calibration curve of IMR intensity against total hCGβ concentration based on standard hCGβ samples, and used an IMR assay to detect total hCGβ concentrations in the urine of pregnant women with lower abdominal pain and/or vaginal bleeding. The final diagnosis of ectopic pregnancy was based on ultrasound scans, operative findings, and pathology reports. In this prospective study, ten clinical samples were used to analyze the relationship of total hCGβ IMR signals between urine and serum. Furthermore, 20 clinical samples were used to analyze the relationship between urine IMR signals and serum levels of total hCGβ. RESULTS The calibration curve extended from 0.01 ng/mL to 10,000 ng/mL with an excellent correlation (R(2)=0.999). In addition, an excellent correlation of total hCGβ IMR signals between urine and serum was noted (R(2)=0.994). Furthermore, a high correlation between urine IMR signals and serum levels of total hCGβ was noted (R(2)=0.862). CONCLUSION An IMR assay can quantitatively analyze total hCGβ concentrations in urine, and is a potential candidate for point-of-care testing to assist in the diagnosis of ectopic pregnancy.
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Affiliation(s)
- Chen-Yu Chen
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan ; Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan ; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Yuh-Ming Hwu
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chie-Pein Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chia-Chen Chang
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
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16
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Schindelhauer-Deutscher HJ, Henn W. Genetische Beratung bei Pränataldiagnostik. MED GENET-BERLIN 2014. [DOI: 10.1007/s11825-014-0027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Zusammenfassung
Vor und nach jeder Pränataldiagnostik muss nach § 15 Abs. 3 des Gendiagnostikgesetzes verpflichtend eine genetische Beratung erfolgen, mit der die Schwangere in die Lage versetzt werden soll, eigenverantwortlich über die Inanspruchnahme der Untersuchung zu entscheiden und deren Ergebnisse für sich zu bewerten. Die in diesem Kommunikationsprozess zu vermittelnden Inhalte umfassen über medizinisch-genetische Fakten hinaus auch psychosoziale und ethische Aspekte, was die Einbindung nichtärztlicher Professionen nahelegen kann. Die Etablierung der nichtinvasiven Pränataldiagnostik hat erhebliche Auswirkungen auf Nutzen-Risiko-Abwägungen und damit auch auf die genetische Beratung. Im ergebnisoffenen Prozess der genetischen Beratung muss die Entscheidungsautonomie der Ratsuchenden respektiert, aber auch eigenen Wertvorstellungen der Berater Raum gegeben werden.
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Affiliation(s)
- H. Joachim Schindelhauer-Deutscher
- Aff1 grid.11749.3a 0000000121677588 Institut für Humangenetik Universität des Saarlandes Universitätsklinikum Bau 68 66421 Homburg/Saar Deutschland
| | - Wolfram Henn
- Aff1 grid.11749.3a 0000000121677588 Institut für Humangenetik Universität des Saarlandes Universitätsklinikum Bau 68 66421 Homburg/Saar Deutschland
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17
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Giorlandino C, Mesoraca A, Bizzoco D, Dello Russo C, Cima A, Di Giacomo G, Cignini P, Padula F, Dugo N, D'Emidio L, Brizzi C, Raffio R, Milite V, Mangiafico L, Coco C, Carcioppolo O, Vigna R, Mastrandrea M, Mobili L. Introducing the next generation sequencing in genomic amnio and villuos sampling. The so called "Next Generation Prenatal Diagnosis" (NGPD). J Prenat Med 2014; 8:1-10. [PMID: 25332753 PMCID: PMC4187001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Claudio Giorlandino
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Alvaro Mesoraca
- Artemisia Fetal Maternal Medical Centre, Department of Genetics, Rome, Italy
| | - Domenico Bizzoco
- Artemisia Fetal Maternal Medical Centre, Department of Genetics, Rome, Italy
| | - Claudio Dello Russo
- Artemisia Fetal Maternal Medical Centre, Department of Genetics, Rome, Italy
| | - Antonella Cima
- Artemisia Fetal Maternal Medical Centre, Department of Genetics, Rome, Italy
| | - Gianluca Di Giacomo
- Artemisia Fetal Maternal Medical Centre, Department of Genetics, Rome, Italy
| | - Pietro Cignini
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Francesco Padula
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Nella Dugo
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Laura D'Emidio
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Cristiana Brizzi
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Raffaella Raffio
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Vincenzo Milite
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Lucia Mangiafico
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Claudio Coco
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Ornella Carcioppolo
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | - Roberto Vigna
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
| | | | - Luisa Mobili
- Artemisia Fetal Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy
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