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Arslan E, Allshouse AA, Page JM, Varner MW, Thorsten V, Parker C, Dudley DJ, Saade GR, Goldenberg RL, Stoll BJ, Hogue CJ, Bukowski R, Conway D, Pinar H, Reddy UM, Silver RM. Maternal serum fructosamine levels and stillbirth: a case-control study of the Stillbirth Collaborative Research Network. BJOG 2021; 129:619-626. [PMID: 34529344 DOI: 10.1111/1471-0528.16922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/12/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the association between maternal fructosamine levels at the time of delivery and stillbirth. DESIGN Secondary analysis of a case-control study. SETTING Multicentre study of five geographic catchment areas in the USA. POPULATION All singleton stillbirths with known diabetes status and fructosamine measurement, and representative live birth controls. MAIN OUTCOME MEASURES Fructosamine levels in stillbirths and live births among groups were adjusted for potential confounding factors, including diabetes. Optimal thresholds of fructosamine to discriminate stillbirth and live birth. RESULTS A total of 529 women with a stillbirth and 1499 women with a live birth were included in the analysis. Mean fructosamine levels were significantly higher in women with a stillbirth than in women with a live birth after adjustment (177 ± 3.05 versus 165 ± 2.89 μmol/L, P < 0.001). The difference in fructosamine levels between stillbirths and live births was greater among women with diabetes (194 ± 8.54 versus 162 ± 3.21 μmol/L), compared with women without diabetes (171 ± 2.50 versus 162 ± 2.56 μmol/L). The area under the curve (AUC) for fructosamine level and stillbirth was 0.634 (0.605-0.663) overall, 0.713 (0.624-0.802) with diabetes and 0.625 (0.595-0.656) with no diabetes. CONCLUSIONS Maternal fructosamine levels at the time of delivery were higher in women with stillbirth compared with women with live birth. Differences were substantial in women with diabetes, suggesting a potential benefit of glycaemic control in women with diabetes during pregnancy. The small differences noted in women without diabetes are not likely to justify routine screening in all cases of stillbirth. TWEETABLE ABSTRACT Maternal serum fructosamine levels are higher in women with stillbirth than in women with live birth, especially in women with diabetes.
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Affiliation(s)
- E Arslan
- Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - A A Allshouse
- Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - J M Page
- Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Obstetrics and Gynecology, Intermountain Health Care, Murray, Utah, USA
| | - M W Varner
- Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - V Thorsten
- RTI International, Research Triangle Park, North Carolina, USA
| | - C Parker
- RTI International, Research Triangle Park, North Carolina, USA
| | - D J Dudley
- Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia, USA
| | - G R Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - R L Goldenberg
- Department of Obstetrics and Gynecology, Columbia University, New York, New York, USA
| | - B J Stoll
- Department of Pediatrics, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - C J Hogue
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - R Bukowski
- Department of Women's Health, University of Texas Health Science Center at Austin, Austin, Texas, USA
| | - D Conway
- Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - H Pinar
- Division of Perinatal Pathology, Brown University School of Medicine, Providence, Rhode Island, USA
| | - U M Reddy
- Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, Connecticut, USA
| | - R M Silver
- Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah, USA
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Son SL, Allshouse AA, Page JM, Debbink MP, Pinar H, Reddy U, Gibbins KJ, Stoll BJ, Parker CB, Dudley DJ, Varner MW, Silver RM. Stillbirth and fetal anomalies: secondary analysis of a case-control study. BJOG 2021; 128:252-258. [PMID: 32946651 PMCID: PMC7902300 DOI: 10.1111/1471-0528.16517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Approximately 10% of stillbirths are attributed to fetal anomalies, but anomalies are also common in live births. We aimed to assess the relationship between anomalies, by system and stillbirth. DESIGN Secondary analysis of a prospective, case-control study. SETTING Multicentre, 59 hospitals in five regional catchment areas in the USA. POPULATION OR SAMPLE All stillbirths and representative live birth controls. METHODS Standardised postmortem examinations performed in stillbirths, medical record abstraction for stillbirths and live births. MAIN OUTCOME MEASURES Incidence of major anomalies, by type, compared between stillbirths and live births with univariable and multivariable analyses using weighted analysis to account for study design and differential consent. RESULTS Of 465 singleton stillbirths included, 23.4% had one or more major anomalies compared with 4.3% of 1871 live births. Having an anomaly increased the odds of stillbirth; an increasing number of anomalies was more highly associated with stillbirth. Regardless of organ system affected, the presence of an anomaly increased the odds of stillbirth. These relationships remained significant if stillbirths with known genetic abnormalities were excluded. After multivariable analyses, the adjusted odds ratio (aOR) of stillbirth for any anomaly was 4.33 (95% CI 2.80-6.70) and the systems most strongly associated with stillbirth were cystic hygroma (aOR 29.97, 95% CI 5.85-153.57), and thoracic (aOR16.18, 95% CI 4.30-60.94) and craniofacial (aOR 35.25, 95% CI 9.22-134.68) systems. CONCLUSIONS In pregnancies affected by anomalies, the odds of stillbirth are higher with increasing numbers of anomalies. Anomalies of nearly any organ system increased the odds of stillbirth even when adjusting for gestational age and maternal race. TWEETABLE ABSTRACT Stillbirth risk increases with anomalies of nearly any organ system and with number of anomalies seen.
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Affiliation(s)
- S L Son
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA
| | - A A Allshouse
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
| | - J M Page
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA
| | - M P Debbink
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA
| | - H Pinar
- Division of Perinatal Pathology, Alpert Medical School of Brown University, Providence, RI, USA
| | - U Reddy
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, CT, USA
| | - K J Gibbins
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
| | - B J Stoll
- Department of Pediatrics, University of Texas Health McGovern Medical School, Houston, TX, USA
| | - C B Parker
- RTI International, Research Triangle Park, NC, USA
| | - D J Dudley
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - M W Varner
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA
| | - R M Silver
- Division of Maternal-Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA
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Page JM. Improved stillbirth risk stratification, an urgent global need. BJOG 2020; 128:225. [PMID: 33006825 DOI: 10.1111/1471-0528.16548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- J M Page
- Intermountain Health Care Inc., Salt Lake City, UT, USA
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Starnes SL, Wolk SW, Lampman RM, Shanley CJ, Prager RL, Kong BK, Fowler JJ, Page JM, Babcock SL, Lange LA, Erlandson EE, Whitehouse WM. Noninvasive evaluation of hand circulation before radial artery harvest for coronary artery bypass grafting. J Thorac Cardiovasc Surg 1999; 117:261-6. [PMID: 9918966 DOI: 10.1016/s0022-5223(99)70421-6] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Radial artery harvesting for coronary artery bypass may lead to digit ischemia if collateral hand circulation is inadequate. The modified Allen's test is the most common preoperative screening test used. Unfortunately, this test has high false-positive and false-negative rates. The purpose of this study was to compare the results of a modified Allen's test with digit pressure change during radial artery compression for assessing collateral circulation before radial artery harvest. METHODS One hundred twenty-nine consecutive patients were studied before coronary artery bypass operations. A modified Allen's test was performed with Doppler ultrasound to assess blood flow in the superficial palmar arch before and during radial artery compression. A decreased audible Doppler signal after radial artery compression was considered a positive modified Allen's test. First and second digit pressures were measured before and during radial artery compression. A decrease in digit pressure of 40 mm Hg or more (digit DeltaP) with radial artery compression was considered positive. RESULTS Seven of 14 dominant extremities (50%) and 8 of the 16 nondominant extremities (50%) with a positive modified Allen's test had a digit DeltaP of less than 40 mm Hg (false positive). Sixteen of 115 dominant extremities (14%) and 5 of 112 nondominant extremities (4%) with a negative Allen's test had a digit DeltaP of 40 mm Hg or more with radial artery compression (false negative). CONCLUSION Use of the modified Allen's test for screening before radial artery harvest may unnecessarily exclude some patients from use of this conduit and may also place a number of patients at risk for digit ischemia from such harvest. Direct digit pressure measurement is a simple, objective method that may more precisely select patients for radial artery harvest. Additional studies are needed to define objective digital pressure criteria that will accurately predict patients at risk for hand ischemia after radial harvest.
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Affiliation(s)
- S L Starnes
- Sections of Vascular and Cardiac and Thoracic Surgery, Department of Surgery, and Michigan Heart and Vascular Institute, St Joseph Mercy Hospital, Ann Arbor, Mich. 48106, USA
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Page JM, Schneeweiss S, Whyte HE, Harvey P. Ocular sequelae in premature infants. Pediatrics 1993; 92:787-90. [PMID: 8233737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The authors report on the incidence of myopia and strabismus at 12 and 24 months postterm in a cohort of 190 premature infants with birth weights of less than 1251 g born in 1986 and 1987. METHODS The neonatal and follow-up eye charts of a cohort of 190 premature infants were retrospectively reviewed. All 138 children who survived the neonatal period had at least one eye examination between day 28 and 42 of life that documented the presence and staging of retinopathy of prematurity (ROP) according to the International Classification of ROP. No infants received cryotherapy. Eye examinations conducted at 12 and 24 months postterm included assessment of vision, fundus, ocular motility, anterior segment abnormality, and refractive error. Eyes were refracted using cycloplegic retinoscopy. Strabismus was detected using the Hirschberg and cover tests. Eye reports were available for 80% (n = 110) at 12 months and 36% (n = 50) at 24 months. RESULTS Fifty-three percent of the cohort exhibited ROP in the neonatal period; 12% of these progressed to stage 3 or 4 ROP. Myopia was observed in 16% (18/110) of the cohort at 12 months of age; 4.5% (5/110) measured more than 4.0 diopters of myopia. Children with birth weights of less than 751 g were 3.2 times more likely than those with birth weights between 751 and 1000 g and 10 times more likely than those with birth weights between 1001 and 1250 g to develop myopia in the first year of life. The likelihood of myopia at 12 months doubled with each increment in ROP stage. Of the 50 children reexamined at 24 months postterm, more than 80% demonstrated deteriorating vision. The incidence of myopia increased to 38% (19/50) overall, with 24% (12/50) of the cohort showing severe myopia. Astigmatism and anisometropia were highly correlated with severe myopia. Strabismus was seen with increasing frequency through the second year of life. All children with grade III or IV intraventricular hemorrhage in the neonatal period developed esotropia. CONCLUSION This study emphasizes the significant roles of low birth weight, ROP, and intraventricular hemorrhage in the development of myopia and strabismus. Follow-up to 2 years of life is recommended given the demonstrated deterioration in our cohort.
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Affiliation(s)
- J M Page
- Department of Nursing, Hospital for Sick Children, Toronto, Ontario, Canada
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West MR, Page JM, Turner DM, Wood EJ, Holland DB, Cunliffe WJ, Rupniak HT. Simple assays of retinoid activity as potential screens for compounds that may be useful in treatment of psoriasis. J Invest Dermatol 1992; 99:95-100. [PMID: 1376755 DOI: 10.1111/1523-1747.ep12611880] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Human epidermal cell cultures were used to study the effects of retinoids on keratinocyte differentiation. Keratin profiles were studied by quantitative gel electrophoresis of culture extracts, whereas the extent of envelope formation was assessed in an enzyme-linked immunosorbent assay (ELISA) using an antibody that specifically recognizes keratinocyte envelopes. Exposure of cultures to a variety of different retinoids produced both dose-dependent decreases in keratin 16 with consequent increases in the keratin 14: keratin 16 ratio, and a decrease in envelope formation. The order of activity in both assays was similar: arotinoid ethyl ester (Ro 13-6298) greater than or equal to arotinoid acid (Ro 13-7410) much greater than all trans retinoic acid (Ro 1-5488) greater than acitretin (Ro 10-1670) greater than or equal to etretinate (Ro 10-9359), the only difference being that acitretin was slightly more active than etretinate in the keratin assay whereas these retinoids were equi-active in the envelope assay. Analysis of the lesional keratins of psoriasis patients showed that etretinate caused a reduction in keratin 16 and an increase in the keratin 14:keratin 16 ratio, although the magnitude of these changes and their correlation with clinical improvement was variable. As the in vitro assays reported here are simple and quick, they allow rapid screening of compounds for retinoid-like activity.
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Affiliation(s)
- M R West
- Department of Cellular Science, Glaxo Group Research, Middlesex, U.K
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Page JM. Central auditory processing disorders in children. Otolaryngol Clin North Am 1985; 18:323-35. [PMID: 4011257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Central auditory processing disorders in children are introduced and defined. The article explains who should be evaluated and for what reasons. The evaluation process, test stimuli, and use of assessment findings are presented.
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Parker LH, Cataldo MF, Bourland G, Emurian CS, Corbin RJ, Page JM. Operant treatment of orofacial dysfunction in neuromuscular disorders. J Appl Behav Anal 1984; 17:413-27. [PMID: 6526764 PMCID: PMC1307964 DOI: 10.1901/jaba.1984.17-413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The popularity and reported success of biofeedback treatment for neuromuscular disorders has occurred despite a lack of research identifying the critical variables responsible for therapeutic gain. In this study, we assessed the degree to which severe neurological dysfunction could be improved by using one of the components present in all biofeedback treatment, contingency management. Three cases of orofacial dysfunction were treated by reinforcing specific improvements reliably detectable without the use of biofeedback equipment. The results showed that contingency management procedures alone were sufficient to improve overt motor responses but, unlike biofeedback treatment, did not produce decreases in the hypertonic muscle groups associated with the trained motor behavior. The findings suggest that sophisticated, expensive biofeedback equipment may not be necessary in treating some neuromuscular disorders and that important clinical gains may be achieved by redesigning the patient's daily environment to be contingently therapeutic, rather than only accommodating the disabilities of the physically handicapped.
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Page JM. Audiology: a problem oriented approach. Otolaryngol Clin North Am 1978; 11:801-11. [PMID: 733261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bunyan PJ, Page JM. Pesticide-induced changes in hepatic microsomal enzyme systems. Some effects of 1,1-di(p-chlorophenyl)-2,2-dichloroethylene (DDE) and 1,1-di(p-chlorophenyl)-2-chloroethylene (DDMU) in the rat and Japanese quail. Chem Biol Interact 1973; 6:249-57. [PMID: 4704124 DOI: 10.1016/0009-2797(73)90052-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Page JM. Audiologic tests in the differential diagnosis of vertigo. Otolaryngol Clin North Am 1973; 6:53-71. [PMID: 4220287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Page JM. A diagnostic multi-disciplinary approach to handicapped children. Pa Med 1972; 75:89-90. [PMID: 4261317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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